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新发传染病电子杂志 ›› 2025, Vol. 10 ›› Issue (4): 13-18.doi: 10.19871/j.cnki.xfcrbzz.2025.04.003

• 专家述评 • 上一篇    下一篇

重视支气管镜技术在肺部感染性疾病诊断中的应用

丁卫民   

  1. 首都医科大学附属北京胸科医院内镜诊疗中心及结核内科门诊,北京 101149
  • 收稿日期:2025-01-18 出版日期:2025-08-31 发布日期:2025-09-18
  • 通讯作者: 丁卫民,Email:dwm6606@163.com
  • 基金资助:
    北京市临床重点专科项目(20201214)

Pay more attention to the application of bronchoscopy in the clinical diagnosis of pulmonary infectious diseases

Ding Weimin   

  1. Endoscopy Diagnosis and Treatment Center and Outpatient Clinic for Tuberculosis and Internal Medicine of Beijing Chest Hospital, Capital Medical University,Beijing 101149, China
  • Received:2025-01-18 Online:2025-08-31 Published:2025-09-18

摘要: 肺部感染性疾病的病原体早期精准检测是临床治愈重症肺部感染、预防轻症转化为重症及遏制传染性肺部感染广泛传播的关键。既往多收集痰液等标本进行病原学检测,传统标本获取困难时,支气管镜技术为获取下呼吸标本提供了帮助。经支气管镜介入到下呼吸道病灶处或病灶引流支气管开口,可以通过直视及引导下精准地实施活检、针吸、刷检、冲洗及灌洗等检查诊断技术,获取活检组织、针吸物、刷检物、冲洗液及灌洗液标本,来进行精准的病原学、病理学及分子生物学等检测。借助于常规支气管镜技术观察并获取中心气道病变标本较易,但针对取样较为困难的周围性病变,如何精准定位取样是当今临床研究的热门话题及面临的挑战。特殊类型支气管镜及导航支气管镜技术应运而生,尤其是机器人辅助支气管镜检查等人工智能(artificial intelligence,AI)技术的探索应用,将真正实现精准取样及检测——支气管镜下探寻真实的感染病原体。

关键词: 肺部感染, 支气管镜, 人工智能技术, 病原学, 病理学, 分子生物学

Abstract: Early and accurate detection of pathogens in pulmonary infections is crucial for the clinical treatment of severe cases, the prevention of mild infections progressing to severe ones, and for control of widespread transmission of infectious pulmonary diseases. In the past, specimens such as sputum and gastric fluid were collected for etiological testing. When traditional specimens are difficult to obtain, bronchoscopy has gained increasing clinical attention as a method for acquiring more accurate specimens to diagnose lower respiratory tract infections. Following bronchoscopic intervention at the lesion site in the lower respiratory tract or the opening of the lesion's drainage bronchus, diagnostic techniques such as biopsy, needle aspiration, brushing, washing, and lavage can be precisely performed under direct visualization and guidance. The specimens obtained through these sampling methods can then be accurately analyzed for etiology, pathology and molecular biology. Conventional bronchoscopy allows for easy observation and specimen collection from central airway lesions, however, sampling peripheral lesions remains challenging. Accurate localization and sampling of such lesions are currently a hot topic and a significant challenge in clinical research. Advancement of specialized bronchoscopy techniques and navigational bronchoscopy,particularly the exploration and application of AI technology such as robot-assisted bronchoscopy, the era of precise sampling and detection--identifying true infectious pathogens through bronchoscopy—is becoming a reality.

Key words: Lung infection, Bronchoscopy, Artificial Intelligence technology, Etiology, Pathology, Molecular biology

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