支气管超声下经引导鞘肺活检术诊断肺周围性疾病的价值

doi:10.6040/j.issn.1671-7554.0.2016.1005

摘要/Abstract

摘要： 目的评价支气管超声下经引导鞘肺活检术(EBUS-GS-TBLB)对肺周围性病变(PPL)的诊断价值和安全性,考察提高EBUS-GS-TBLB诊断阳性率的相关因素。方法回顾性分析2015年1月至2016年3月于山东大学第二医院在不同引导设备下行经支气管肺组织活检的67例PPL患者的临床资料,根据引导设备的不同分为传统组(n=38)和支气管超声导向鞘(EBUS-GS)组(n=29);比较两组间的诊断率及影响EBUS-GS-TBLB诊断阳性率的相关因素。结果传统组和EBUS-GS组在性别、年龄、病灶大小上的差异无统计学意义(P>0.05),两组具有可比性。传统组、EBUS-GS组的诊断率分别为47.4%(18/38)和75.9%(22/29),差异有统计学意义(χ2=5.55, P=0.018)。EBUS-GS组中EBUS-GS-TBLB对病灶直径>2 cm的诊断率为94.1%(16/17),病灶直径≤2 cm的诊断率为50.0%(6/12),差异有统计学意义(P=0.011)。EBUS-GS-TBLB中超声探头能穿过病灶的诊断阳性率为89.4%(17/19),探头不能穿过病灶的诊断阳性率为50.0%(5/10),差异有统计学意义(P=0.030)。EBUS-GS-TBLB诊断率与病灶的位置无明显相关性(P>0.05)。结论 EBUS-GS-TBLB可提高肺周围性疾病的诊断率,并发症少,用于诊断PPL安全有效。EBUS-GS-TBLB诊断的阳性率与病灶的大小、超声探头及病灶关系等因素有关。

关键词: 支气管镜检查, 超声介入, 活组织检查, 肺周围性病变

Abstract: Objective To evaluate the diagnostic value and safety of endobronchial ultrasound transbronchial lung biopsy with guide-sheath(EBUS-GS-TBLB)in peripheral pulmonary lesions(PPL), and to investigate the related factors of improving EBUS-GS-TBLB diagnostic rate. Methods A total of 67 patients with suspected PPL who underwent transbronchial lung biopsy in the Department of Respiratory Medicine of the Second Hospital of Shandong University between January 2015 and March 2016 were prospectively evaluated. The patients were divided into the conventional group(n=38)and the endobronchial ultrasound group with guide sheath group(EBUS-GS group, n=29). The diagnostic rate and the related factors were analyzed. Results There was no significant difference in gender, age and lesion size of the two groups(P>0.05). The diagnostic rate of the EBUS-GS group was 75.9%(22/29), which was higher than that of the conventional group, 47.4%(18/38),(χ2=5.55, P=0.018). In EBUS-GS group, the diagnostic rate of the lesion diameter >2 cm was 94.1%(16/17), while the lesion diameter ≤2 cm was 50.0%(6/12). The difference was statistically significant(P=0.011). The diagnostic rate of EBUS probe within the lesions was 89.4%(17/19), while probe outside the lesions was 50.0%(5/10). The difference was statistically significant(P=0.030). There was no correlation between the diagnostic rate and the location of the lesions(P>0.05)in EBUS-GS- 山东大学学报 (医学版)55卷4期 -张华楠,等.支气管超声下经引导鞘肺活检术诊断肺周围性疾病的价值 \=-TBLB. Conclusion The procedure of EBUS-GS-TBLB is minimally invasive, has higher diagnostic rate and fewer complications, so it is a safe and effective method to diagnose PPL. The diagnostic rate of EBUS-GS-TBLB is related to both the lesion size and ultrasonic probe position.

Key words: Bronchoscopy, Peripheral pulmonary lesions, Uhrasonography interventional, Biopsy

中图分类号:

R574

张华楠,王超超,张媛,徐少华,王莹,王伟. 支气管超声下经引导鞘肺活检术诊断肺周围性疾病的价值[J]. 山东大学学报（医学版）, 2017, 55(4): 34-38.

ZHANG Huanan, WANG Chaochao, ZHANG Yuan, XU Shaohua, WANG Ying, WANG Wei. Endobronchial ultrasound transbronchial lung biopsy with guide-sheath for the diagnosis of pulmonary peripheral lesions[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(4): 34-38.

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