摘要
目的评价支气管镜下径向超声引导联合测量技术经支气管活检(REBUS-D-TBB)在肺周围性病变(PPLs)中的诊断效能、安全性和影响因素。方法回顾性分析中国医科大学附属第一医院呼吸内镜室2017年4月20日年至2018年4月28日行REBUS-D-TBB的65例PPLs患者的临床资料,分析该技术的诊断率、安全性和影响因素。结果REBUS-D-TBB在PPLs中的总诊断率为58.5%(38/65),其中恶性肿瘤诊断率为71.1%(32/45),良性疾病诊断率为33.3%(6/18)。病灶大小(直径>20mm)、超声探头与病灶关系(探头在病灶内)、活检的次数(>5次)是影响诊断效能的因素,病灶在肺叶的分布对诊断无明显影响。2例患者活检后出现中等量出血(50ml左右),经局部喷洒凝血酶后,出血停止;余患者活检后见少量出血,无需处理。结论REBUS-D-TBB在诊断PPLs中具有较高的应用价值,安全性高,选择合适的患者能提高诊断率。
Objective To evaluate efficacy, safety and influencing factors of radial endobronchial ultrasound with distance transbronchial biopsy (REBUS-D-TBB) in the diagnosis of peripheral pulmonary lesions (PPLs). Methods Clinical data of 65 patients with PPLs who underwent REBUS-D-TBB in the First Affiliated Hospital of China Medical University from April 20, 2017 to April 28, 2018 were retrospectively analysed to evaluate its diagnostic yield, safety and influencing factors. Results The overall diagnostic yield was 58.5%(38/65) in REBUS-D-TBB for PPLs, and the diagnostic yield was 71.1%(32/45) for malignant tumors and was 33.3%(6/18) for benign diseases.Lesion size (diameter >20 mm), probe position (within the lesions) and the number of biopsies (>5) influenced the diagnostic yield, distribution of lesions in the lobe showed no significant effect on diagnostic yield.Moderate bleeding (about 50 ml) was observed in two patients after biopsy, and bleeding stopped after hemocoagulase was sprayed locally, the remaining patients showed only a small amount of bleeding after biopsy which stopped spontaneously. Conclusions REBUS-D-TBB is both effective and safe in the diagnosis of PPLs, chosing suitable patients can improve the diagnostic yield.
作者
黎威
马海峰
马文会
张勤
侯刚
Li Wei;Ma Haifeng;Ma Wenhui;Zhang Qin;Hou Gang(Institute of Respiratory Disease, the First Affiliated Hospital of China Medical University, Shenyang 110001, China)
出处
《国际呼吸杂志》
2019年第3期191-195,共5页
International Journal of Respiration
关键词
支气管内超声检查
经支气管活检
肺周围性病变
诊断
Endobronchial ultrasound
Transbronchial biopsy
Peripheral pulmonary lesions
Diagnosis
