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首页> 外文期刊>BMJ Open Respiratory Research >Comparative outcomes of inpatients with lung collapse managed by bronchoscopic or conservative means
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Comparative outcomes of inpatients with lung collapse managed by bronchoscopic or conservative means

机译：支气管镜或保守治疗对肺萎陷住院患者的比较结果

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Background Although the incidence and prevalence of atelectatic lung collapse is unknown, such events are common among inpatients, and there are no guidelines for optimally instituting bronchoscopic techniques. The aim of this study was to evaluate the outcomes of patients with complete or near-complete lung collapse managed via interventional flexible fibreoptic bronchoscopy or a conservative approach.Methods Retrospective analysis of all adult patients admitted to BronxCare Health System between January 2011 and October 2017 with a diagnosis of lung collapse/atelectasis. The primary outcome was radiological resolution. Timing of bronchoscopy relative to radiological resolution and mortality served as secondary outcomes.Results Of the 177 patients meeting inclusion criteria, 149 (84%) underwent bronchoscopy and 28 (16%) were managed through conservative measures only. A significantly greater number of patients in the bronchoscopy group achieved complete or near-complete resolution on chest X-ray, compared with the conservative group (p=0.007). Timing of bronchoscopy had no impact on the rate of radiological resolution, and mortality in the two groups was similar. New endobronchial malignancies were identified in 21 patients (14%).Conclusions Our data support the central role of bronchoscopy in instances of complete or near-complete lung collapse, ensuring better radiological outcomes. Judicious use of conservative management is warranted to avoid missing significant pathology. A prime consideration in this setting is obstructive malignancy.
机译：背景技术尽管不明肺塌陷的发生率和患病率尚不清楚，但此类事件在住院患者中很常见，并且尚无关于最佳设置支气管镜技术的指南。这项研究的目的是评估通过介入性柔性纤维支气管镜检查或保守方法处理的完全或接近完全肺萎陷患者的结局。诊断肺萎陷/肺不张。主要结果是放射学解决。结果符合入选标准的177例患者中，有149例（84％）接受了支气管镜检查，而28例（16％）仅通过保守措施进行了治疗。与保守治疗组相比，支气管镜检查组中有更多数量的患者在胸部X线检查上达到了完全或接近完全的分辨率（p = 0.007）。支气管镜检查的时间对放射线分辨率没有影响，两组的死亡率相似。结论21例新发支气管内恶性肿瘤（占14％）。结论我们的数据支持在完全或接近完全肺塌陷的情况下支气管镜检查的中心作用，确保更好的放射学结果。为避免遗漏重大病理，应谨慎使用保守治疗。在这种情况下，首要考虑因素是阻塞性恶性肿瘤。

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