【摘要】：目的探討超聲支氣管鏡引導(dǎo)下經(jīng)支氣管針吸活檢術(shù)(EBUS-TBNA)在肺及縱隔疾病中的診斷價(jià)值。方法對(duì)50例經(jīng)胸部CT發(fā)現(xiàn)肺門-縱隔淋巴結(jié)腫大和(或)氣管、支氣管旁腫物而行EBUS-TBNA患者的臨床資料進(jìn)行回顧性分析,計(jì)算其診斷肺及縱隔病變的敏感度、特異度和準(zhǔn)確度。結(jié)果 50例患者中明確診斷44例,包括惡性病變36例,良性病變8例,其中診斷縱隔淋巴結(jié)結(jié)核3例、結(jié)節(jié)病3例、臨床診斷為慢性非特異性炎癥2例。共穿刺67組淋巴結(jié)或腫塊,每組平均穿刺2~4針。EBUS-TBNA對(duì)肺及縱隔惡性腫瘤診斷的敏感度、特異度和準(zhǔn)確度分別為92.3%、100%和94%,陽性預(yù)測(cè)值和陰性預(yù)測(cè)值分別為100%和78.6%。EBUS-TBNA對(duì)縱隔及肺內(nèi)病變的診斷敏感度為88%,特異度為100%。患者均未出現(xiàn)嚴(yán)重并發(fā)癥。結(jié)論 EBUS-TBNA在肺及縱隔惡性腫瘤及不明原因肺門-縱隔淋巴結(jié)腫大等疾病診斷方面有較高的敏感度、特異度和準(zhǔn)確度,且并發(fā)癥少。
[Abstract]:Objective to evaluate the diagnostic value of transbronchial needle aspiration (EBUS-TBNA) guided by ultrasound bronchoscope in lung and mediastinal diseases. Methods the clinical data of 50 EBUS-TBNA patients with hilar and mediastinal lymphadenopathy and / or trachea or paracranchial mass found by CT were analyzed retrospectively. The sensitivity, specificity and accuracy of the diagnosis of pulmonary and mediastinal lesions were calculated. Results 44 cases of 50 patients were diagnosed, including 36 malignant lesions and 8 benign lesions, including 3 cases of mediastinal lymph node tuberculosis, 3 cases of sarcoidosis and 2 cases of chronic nonspecific inflammation. A total of 67 groups of lymph nodes or masses were punctured. The sensitivity of EBUS-TBNA to diagnosis of lung and mediastinal malignancy was observed. The specificity and accuracy were 92. 3% and 94% respectively. The positive predictive value and negative predictive value were 100%. The sensitivity and specificity of 78.6%.EBUS-TBNA in diagnosing mediastinal and pulmonary lesions were 88 and 100 respectively. None of the patients had serious complications. Conclusion EBUS-TBNA has high sensitivity, specificity and accuracy in the diagnosis of lung and mediastinal malignant tumors and unknown pulmonary hilar and mediastinal lymphadenopathy, and has fewer complications.
【作者單位】： 山東大學(xué)第二醫(yī)院;
【基金】：山東省科技發(fā)展計(jì)劃項(xiàng)目(2014GSF118116)
【分類號(hào)】：R56

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