【摘要】：目的評價引導鞘管(guide sheath,GS)在非X線下支氣管內徑向超聲引導經支氣管肺活檢(EBUS-TBLB)中對肺外周病灶的診斷價值。方法回顧性分析2012年7月至2015年6月在北京大學第一醫(yī)院行胸部CT檢查發(fā)現(xiàn)肺外周病灶,并在支氣管內徑向超聲引導下行經支氣管肺活檢的患者。根據(jù)活檢操作,將患者分為GS組、非GS組、雙活檢組,對比分析三組的診斷率情況。結果入選118例患者,共126個肺外周病灶,總診斷率為60.3%(76/126)。GS組、非GS組、雙活檢組診斷率分別為65.4%(36/55)、61.5%(8/13)、59.6%(31/52),差異均無統(tǒng)計學意義(χ~2=0.394,P=0.821)。GS組、非GS組、雙活檢組在病灶≤20 mm診斷率分別為66.7%(18/27)、0.0%(0/3)、78.6%(11/14),非GS組診斷率明顯低于其他二組,差異有統(tǒng)計學意義(χ~2=6.8,P=0.033);病灶20 mm診斷率分別為64.3%(18/28)、80.0%(8/10)、54.1%(20/37),三組間差異無統(tǒng)計學意義(χ~2=2.301,P=0.301)。結論 EBUS-TBLB中使用GS在≤20 mm的肺外周病灶中能明顯提高診斷率,20 mm的病灶中不能提高診斷率,GS活檢后更換普通活檢鉗重復活檢不能進一步提高診斷率。
[Abstract]:Objective to evaluate the diagnostic value of guided sheath tube (guide sheath-GS) in non-X ray guided transbronchial lung biopsy (EBUS-TBLB). Methods from July 2012 to June 2015, patients with peripheral lung lesions were examined by chest CT in the first Hospital of Peking University and underwent transbronchial lung biopsy under the guidance of bronchus diameter ultrasound. According to the biopsy procedure, the patients were divided into three groups: GS group, non GS group and double biopsy group. Results there were 126 peripheral pulmonary lesions in 118 patients, the total diagnostic rate was 60.3% (76 / 126). GS group, non-GS group and double biopsy group were 65.4% (36 / 55) or 61.5% (8 / 13) or 59.6% (31 / 52) respectively. There was no significant difference between the two groups. In the double biopsy group, the diagnostic rate of the lesions 鈮，

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