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气道内超声引导鞘技术对于良性周边型肺部病变的诊断

  

  1. 河北医科大学第二医院 呼吸二科,河北 石家庄 050000
  • 出版日期:2016-08-05 发布日期:2016-07-30
  • 通讯作者: 通信作者:潘文森,Email: hebeihuxi@sina.com
  • 基金资助:
    河北省省级科技计划资助项目(16277749D);河北省医学科学研究重点课题计划(ZL20140130)

Endobronchial ultrasound transbronchial lung biopsy with guidesheath for  diagnosis of benign peripheral pulmonary lesions

  1. Second  Department of Respiratory Medicine, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
  • Online:2016-08-05 Published:2016-07-30
  • Contact: Corresponding author: Pan Wensen, Email: hebeihuxi@sina.com

摘要: 目的探讨气道内超声引导鞘(EBUSGS)技术在良性周边型肺部病变中的诊断价值。方法回顾分析常规支气管镜不能确诊的周边型肺部病变(PPL)患者49例,均行EBUSGS检查,分析EBUSGS诊断良、恶性周边型肺部病变的诊断率及安全性指标。结果49例PPL患者,男35例,女14例,年龄35~88岁,平均(63.1±11.1)岁。所有患者均经过肺部CT发现周边型肺部病灶,但经常规支气管镜检查未发现病变。49例患者中,37例可由EBUSGS直接探及病变,占75.5%。恶性病变的诊断率为87.5%(14/16),良性病变为69.7%(23/33) 。所有患者均可很好地耐受检查过程,部分患者可见少量出血,没有发生气胸等严重并发症。结论EBUSGS诊断周边型肺部病变安全有效,对于良性周边型肺部病变也有较好的诊断率。

关键词: 肺疾病;支气管镜检查, 腔内超声检查, 活组织检查, 针吸

Abstract: ObjectiveTo evaluate the diagnostic value of endobronchial ultrasound transbronchial lung biopsy with guidesheath (EBUSGS) in benign peripheral pulmonary lesions(PPL).MethodsRetrospective analysis was performed in 49 patients with PPL inaccessible by conventional bronchoscopy.The diagnostic yield,safety and associated factors were analyzed.ResultsFortynine patients with PPL (35 males and 14 females,age  35 to 88 years,mean [63.1±11.1] years) were confirmed by CT but not detected by conventional bronchoscopy.PPL were examined in 49 patients,and 37 cases with PPL were detected by EBUSGS,and the diagnostic rate was 75.5%.The diagnosis rate of malignant PPL was 87.5% (14/16), while that of benign disease was 69.7%(23/33).All patients tolerated the procedure very well.Mild bleeding was observed in the biopsies of some patients.No pneumothorax or other serious complications were observed.ConclusionThe technique of EBUSGS was safe,and its diagnostic rate was higher to either malignant or benign PPL.

Key words: lung diseases;bronchoscopy, endosonography, biopsy, needle