Safety of fibreoptic bronchoscopy in asthmatic and control subjects and effect on asthma control over two weeks
Safety of fibreoptic bronchoscopy in asthmatic and control subjects and effect on asthma control over two weeks
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DOI：
10.1136/thx.51.7.664
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发表时间：
1996-07-01
期刊：
影响因子：
10
通讯作者：
Durham, SR
中科院分区：
文献类型：
--
作者：
Humbert, M;Robinson, DS;Durham, SR
背景-支气管镜检查在哮喘中的安全性仍然受到关注，并且在支气管镜检查后的几天或几周内，这种方法对哮喘控制效果的数据很少。研究的29名哮喘受试者中有21名可获得手术前后前瞻性收集的呼气峰流速（PEFR）数据。这些结果显示，支气管镜检查后PEFR较基线下降中位数为23%（范围3-58%）。为了确定支气管镜检查后PEFR的下降是否反映了支气管痉挛或镇静作用，在对15名症状性哮喘受试者和20名非哮喘对照者进行的进一步研究中，在支气管镜检查后2小时内进行了PEFR和肺量测定试验。为了检查对哮喘控制的影响，哮喘患者记录PEFR，症状评分，和药物使用两个星期之前和之后支气管镜检查结果-支气管镜检查后，支气管活检有没有差异的中位数最大下降之间的PEFR或动脉血氧饱和度之间的15个哮喘患者（10.4%和4%，分别）和20个控制（12%和3%）。此外，有没有显着的变化，PEFR，症状评分，或药物使用的哮喘受试者在两周后支气管镜检查时相比，前两周bronchoscopic.Conclusions -纤维支气管镜检查是哮喘患者耐受性良好。支气管活检后哮喘和非哮喘受试者PEFR的福尔斯下降可能反映了镇静作用，而不是支气管痉挛。额外的支气管肺泡灌洗可能导致支气管收缩。因此，认真监测至关重要。支气管镜检查和支气管活检后两周的峰值流量监测显示对哮喘控制无延迟影响。
Background - Concerns remain about the safety of bronchoscopy in asthma and there are few data on the effect of this procedure on asthma control in the days or weeks following bronchoscopy.Methods - In an initial study of bronchoalveolar lavage and bronchial biopsies in asthmatic and control subjects, data on peak expiratory flow rates (PEFR) collected prospectively before and after the procedure were available from 21 of the 29 asthmatic subjects studied. These showed a median 23% fall in PEFR from baseline after bronchoscopy (range 3-58%). To determine whether this fall in PEFR following bronchoscopy reflected bronchospasm or the effect of sedation, PEFR and spirometric tests were performed during the two hours following bronchoscopy in a further study of 15 symptomatic asthmatic subjects and 20 non-asthmatic controls. To examine the effect on asthma control, asthmatic patients recorded PEFR, symptom scores, and medication use for two weeks before and after bronchoscopy.Results - After bronchoscopy with bronchial biopsies there was no difference between the median maximal fall in either PEFR or arterial oxygen saturation between the 15 asthmatic patients (10.4% and 4%, respectively) and 20 controls (12% and 3%). Moreover, there were no significant changes in PEFR, symptom score, or medication use by the asthmatic subjects in the two weeks after bronchoscopy when compared with the two weeks before bronchoscopy.Conclusions - Fibreoptic bronchoscopy is well tolerated in asthmatic subjects. Falls in PEFR in both asthmatic and non-asthmatic subjects after bronchial biopsy may reflect the effects of sedation rather than bronchospasm. Additional bronchoalveolar lavage may cause bronchoconstriction. Careful monitoring is therefore essential. Peak flow monitoring up to two weeks after bronchoscopy with bronchial biopsy revealed no delayed effects on asthma control.