胸部X线“三阻征”联合纤维支气管镜筛查中央型肺癌价值研究(2)
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值得注意的是,中央型肺癌即使阻塞所发生的支气管,但极少数患者不一定出现“三阻征”,对照组中2例肺癌属这种情况。造成这种情况的可能原因是阻塞支气管远侧存在有较大的交通支,从而起到代偿通气作用,该2例经手术后得到证实这一点。由于“三阻征”阴性,因而很难发现这种类型的中央型肺癌。
综上所述,胸部X线无明确肿块,40岁以上,有咳痰、咳嗽 、胸痛、发热或痰中带血等症状,同时有阻塞性肺气肿、阻塞性肺炎和阻塞性肺不张等“三阻征”者,即应当行纤维支气管镜筛查,这样做可以提高肺癌的早期诊断。
参考文献
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[6]赵一平,刘白鹭,边 杰.CT动态增强扫描诊断肺癌的初探[J].实用放谢学杂志,2007.23(1):39-42.
[7]原珍团,余建群,杨志刚,等.粟粒型肺结核和粟粒性肺转移瘤的螺旋CT鉴别特征[J].实用放谢学杂志,2006,22(2):195-198.
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(收稿日期:2008-02-15 修回日期:2008-06-03)
(编辑:潘明志)
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