ASSESSMENT OF THE UTILITY OF REPEAT FIBEROPTIC BRONCHOSCOPY IN DIAGNOSIS

免疫功能低下（IC）患者的复发性肺部症状是 这是一个常见的问题，也是诊断和治疗的挑战。 重复FOB经常进行，因为它是相对安全的，更具侵入性 手术可能是禁忌的。本研究的目的是 评价重复FOB对IC的诊断和治疗效果 患者对所有IC患者进行回顾性病历审查 从1987年1月1日到1992年6月30日在我司重复进行FOB。 患者被分为“持续性”肺部疾病 (as通过在初始FOB后30天内进行的重复FOB记录），或 “新”疾病（根据30天后进行的重复FOB记录） 最初的FOB）。在艾滋病毒感染患者中， 在8/25（32%）例新发疾病的重复FOB和2/20（10%）例 持续性疾病（p=NS）。14125年开始改变治疗 (56%）新发疾病重复FOB，7/20（35%）持续性疾病重复FOB （p=NS）。在血液学/肿瘤学疾病中，发现了一种新的诊断， 10/20（50%）例新发疾病重复FOB，12/42（29%）例持续FOB 疾病（p= 0.10）;在14/20（70%）重复治疗中开始改变治疗 新发疾病的FOB，以及24/42例（57%）持续性疾病（p=.NS）。 在其他免疫功能低下的患者中， 在3/10（30%）的新发疾病重复FOB中发现，1/4（25%）的新发疾病重复FOB中发现， 持续性疾病（p=NS）; 5/10例（50%）开始改变治疗 新发疾病重复FOB，2/4（50%）持续性疾病重复FOB。我们 我得出结论，重复FOB的诊断率， 艾滋病毒感染是同样有效的存在新的或持续的 疾病;血液学/肿瘤学疾病和新发疾病患者， 重复FOB可能更有可能建立新的诊断（p=0.10）。一 这些数据的手稿已接近完成，并将提交给 美国呼吸与重症监护医学杂志。这些数据 对支气管镜检查诊断效用的扩展观察， CCMD的研究在过去的十年里。

Recurrent pulmonary symptoms in immunocompromised (IC) patients are a common problem, and they pose diagnostic and therapeutic challenges. Repeat FOB is often performed as it is relatively safe, and more invasive procedures may be contraindicated. The purpose of this study has been to evaluate the diagnostic and therapeutic efficacies of repeat FOB in IC patients. A retrospective chart review was performed for all IC patients undergoing repeat FOB in our Department from 1/1/87 through 6/30/92. Patients were classified as having either "persistent" pulmonary disease (as documented by repeat FOB performed within 30 days of initial FOB), or "new" disease (as documented by repeat FOB performed after 30 days from the initial FOB). In patients with HIV infection, a new diagnosis was found in 8/25 (32%) repeat FOB with new disease and 2/20 (10%) with persistent disease (p=NS). A change in therapy was initiated in 14125 (56%) repeat FOB with new disease, and 7/20 (35%) with persistent disease (p=NS). In hematologic/oncologic disorders, a new diagnosis was found in 10/20 (50%) repeat FOB with new disease, an in 12/42 (29%) with persistent disease (p=O.lO); a change in therapy was initiated in 14/20 (70%) repeat FOB with new disease, and in 24/42 (57%) with persistent disease (p=.NS). In patients with other immunocompromised conditions, a new diagnosis was found in 3/10 (30%) repeat FOB with new disease, and 1/4 (25%) with persistent disease (p=NS); a change in therapy was initiated in 5/10 (50%) repeat FOB with new disease, and in 2/4 (50%) with persistent disease. We have concluded that the diagnostic yield for repeat FOB in patients with HIV infection is equally effective in the presence of new or persistent disease; in patients with hematologic/oncologic disorders and new disease, repeat FOB may be more likely to establish a new diagnosis (p=0.10). A manuscript with these data is nearly completed and will be submitted to the American Journal of Respiratory and Critical Care Medicine. These data extend observations on the diagnostic utility of bronchoscopy, a subject of CCMD research for the past decade.