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硬质支气管镜技术在“真实世界”的争议与思考
任杰1,黄海东1*,王琴1,杨宇光2,黄怡1,李强3,白冲1
0
(1. 第二军医大学长海医院呼吸与危重症医学科, 上海 200433;
2. 第二军医大学长海医院麻醉科, 上海 200433;
3. 上海交通大学附属第一人民医院呼吸科, 上海 200080
*通信作者)
摘要:
硬质支气管镜技术(RB)是一项"古老"的支气管镜技术。自20世纪70年代可弯曲支气管镜技术(FB)兴起后,RB的使用频率迅速下降,许多临床医师质疑RB是否还有临床应用价值。但近年来,国内介入肺脏病领域出现迅速升温的"硬质热"局面使临床医师又心存困惑:为什么RB重新成为国内介入肺脏病领域的热点?RB在肺脏病内镜操作中有什么实际应用价值?RB的发展趋势和应用前景如何?本文针对RB在"真实世界"中的这些争论展开综述和讨论,并结合本领域最新进展提出我们的思考和观点。
关键词:  介入肺病学  硬质支气管镜检查  可弯曲支气管镜检查  硅酮支架  激光消融  冷冻消融
DOI:10.16781/j.0258-879x.2018.02.0117
投稿时间:2017-10-26修订日期:2017-12-30
基金项目:国家公益性行业科研专项(201402024),长海医院首批医疗新技术培育项目(NT201506).
Rigid bronchoscopy in the real world: controversies and thinking
REN Jie1,HUANG Hai-dong1*,WANG Qin1,YANG Yu-guang2,HUANG Yi1,LI Qiang3,BAI Chong1
(1. Department of Respiratory and Critical Care Medicine, Changhai Hospital, Second Military Medical University, Shanghai 200433, China;
2. Department of Anesthesiology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China;
3. Department of Respiratory Medicine, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai 200080, China
*Corresponding author)
Abstract:
Rigid bronchoscopy (RB) is one of the oldest bronchoscopic techniques. Since the advent of flexible bronchoscopy (FB) in 1970s, usage frequency of RB procedures has rapidly decreased, which made many clinicians question its clinical value. However, the fact of prosperous"rigid hot"in China has appeared in the field of interventional pulmonology in recent years, which confused some pulmonologists-why does RB become hot in the field of interventional pulmonology domestically? what is the practical value of RB in the endoscopic procedures of modern respiratory diseases? how about the developing trend and application prospects of RB in future? This review summarized and discussed the existing debates as well as the latest progress on RB in clinical application, and put forward our views and opinions.
Key words:  interventional pulmonology  rigid bronchoscopy  flexible bronchoscopy  silicone stent  laser ablation  cryoablation