本文關(guān)鍵詞： 超聲內(nèi)鏡 細(xì)針穿刺活檢 消化道壁外占位性病變 診斷 并發(fā)癥　出處：《河北醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探討超聲內(nèi)鏡引導(dǎo)下細(xì)針穿刺活檢(EUS-FNA)對(duì)消化道壁外占位性病變的診斷價(jià)值。方法:通過檢索河北醫(yī)科大學(xué)第二醫(yī)院消化內(nèi)鏡室數(shù)據(jù)庫,篩選出自2014年6月至2016年12月行超聲內(nèi)鏡引導(dǎo)下細(xì)針穿刺活檢術(shù)的患者22例。這些患者均為經(jīng)B超、CT或MRI檢查可疑消化道壁外占位性病變(包括胰腺、縱膈、腹腔)的住院患者。其中,男12例,女10例,年齡34-81歲�？v膈占位8例、胰腺占位13例(實(shí)性占位11例,囊性占位2例)、腹腔占位1例。患者的穿刺樣本送組織病理學(xué)、液基細(xì)胞學(xué)或病理涂片檢查�？梢山Y(jié)核病變的送抗酸染色和TB-DNA檢查。胰腺囊性病變所得囊液送CA-199、CEA及CA-125檢測。追蹤患者術(shù)后的病理結(jié)果、并發(fā)癥的發(fā)生、后續(xù)的治療及轉(zhuǎn)歸情況。結(jié)果:1 EUS-FNA作為消化道壁外占位性病變的診斷方法,安全、成功率高,并發(fā)癥少見。2 EUS-FNA鑒別消化道壁外占位性病變良惡性的總體靈敏度、特異度、陽性預(yù)測值、陰性預(yù)測值及準(zhǔn)確率分別為:88.9%、100%、100%、66.7%、90.9%。3 EUS-FNA的穿刺次數(shù)≥3次與3次的診斷準(zhǔn)確性一致。EUS-FNA在胰腺和縱膈的診斷準(zhǔn)確性一致。4 EUS-FNA的標(biāo)本行組織病理學(xué)、液基細(xì)胞學(xué)及病理涂片的診斷準(zhǔn)確性一致。結(jié)論:EUS-FNA在鑒別消化道壁外占位性病變良惡性上是一種安全、有效且準(zhǔn)確的方法,并發(fā)癥少見。穿刺針數(shù)、部位、標(biāo)本處理方法對(duì)其診斷準(zhǔn)確性上無明顯影響。
[Abstract]:Objective: to investigate the diagnostic value of EUS-FNA-guided endoscopic fine needle biopsy in the diagnosis of extramural space occupying lesions of digestive tract. Methods: the database of digestive endoscopy room in the second Hospital of Hebei Medical University was searched. From June 2014 to December 2016, 22 patients undergoing endoscopic fine needle biopsy were selected. These patients were examined by B-ultrasound CT or MRI for suspected extramural lesions of the digestive tract (including pancreas, mediastinum, mediastinum, pancreas, mediastinum). There were 12 males and 10 females aged 34-81 years, 8 cases with mediastinal mass, 13 cases with pancreatic mass (11 cases with solid space occupying, 2 cases with cystic space occupying, 1 case with abdominal space occupying). Fluid based cytology or pathological smear examination. Acid-fast staining and TB-DNA examination of suspected tuberculosis. Cystic fluid from pancreatic cystic lesions were sent to CA-199C CEA and CA-125. The pathological results and complications of the patients were followed up. Results: as a diagnostic method for extramural space occupying lesions of the digestive tract, 1: 1 EUS-FNA was safe and had a high success rate. The total sensitivity and specificity of 2. 2 EUS-FNA in differentiating benign and malignant lesions were rare. The positive predictive value, the negative predictive value and the accuracy were 88.9% and 66.7%, respectively. The accuracy of the puncture times of 90.9.3 EUS-FNA 鈮，

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