【摘要】：目的評價經(jīng)氣管鏡超聲引導(dǎo)針吸活檢(EBUS-TBNA)與常規(guī)經(jīng)支氣管鏡針吸活檢(C-TBNA)在縱隔及肺門占位性疾病診斷中的價值。方法收集2010年-2016年新醫(yī)大一附院縱隔、肺門占位性疾病患者301例,其中行C-TBNA檢查者183例,行EBUS-TBNA檢查者118例,比較兩種方法穿刺陽性率及并發(fā)癥情況,探究EBUS-TBNA技術(shù)的價值及優(yōu)勢所在。結(jié)果 (1)EBUS-TBNA患者的中央?yún)^(qū)組淋巴結(jié)(2R、4L、4R、7)活檢陽性率高于周圍區(qū)組淋巴結(jié)(10R、10L、11R、11L)(P0.05),EBUS-TBNA于2R、4R、7組淋巴結(jié)活檢陽性率高于C-TBNA組,差異具有統(tǒng)計學(xué)意義(P0.05);(2)EBUS-TBNA于4R和7組淋巴結(jié)穿刺的一針陽性率明顯高于C-TBNA組(P0.05),三針累計陽性率基本接近該穿刺部位總體陽性率(P0.05),可獲得較滿意穿刺效果;(3)EBUS-TBNA組診斷技術(shù)的準確度及敏感度優(yōu)于C-TBNA組(P0.05),尤其對縱隔、肺門良性疾病的檢出率高于C-TBNA組(P0.05);(4)兩組患者并發(fā)癥的發(fā)生率無明顯差異(P0.05)。結(jié)論 EBUS-TBNA對不明原因縱隔、肺門占位或氣管、支氣管腔外病變的診斷具有重要價值,是一種安全、有效的操作技術(shù)。
[Abstract]:Objective to evaluate the value of transtracheal ultrasound guided needle aspiration biopsy (EBUS-TBNA) and conventional transbronchial needle aspiration biopsy (C-TBNA) in the diagnosis of mediastinal and hilar space occupying diseases. Methods from 2010 to 2016, 301 patients with mediastinal and hilar space-occupying diseases in the first affiliated Hospital of New Medical University were collected. Among them, 183 cases underwent C-TBNA examination and 118 cases underwent EBUS-TBNA examination. The positive rates and complications of puncture were compared between the two methods. Explore the value and advantages of EBUS-TBNA technology. Results (1) the positive rate of biopsy in the central lymph nodes (2R, 4L, 4R, 7) of the patients with EBUS-TBNA was higher than that in the peripheral lymph nodes (10R, 10L, 11R, 11L) (P0.05), and the EBUS-TBNA was 2R, 4R. The positive rate of lymph node biopsy in 7 groups was significantly higher than that in C-TBNA group (P0.05). (2) the positive rate of EBUS-TBNA in 4R and 7 groups was significantly higher than that in C-TBNA group (P0.05), and the cumulative positive rate of three needles was close to the overall positive rate of the puncture site (P0.05). (3) the diagnostic accuracy and sensitivity of EBUS-TBNA group was better than that of C-TBNA group (P0.05), especially for mediastinal and hilar benign diseases, the detection rate of benign disease was higher than that of C-TBNA group (P0.05). (4) there was no significant difference in the incidence of complications between the two groups (P0.05). Conclusion EBUS-TBNA is a safe and effective technique for the diagnosis of unknown mediastinal, hilar space occupying, tracheobronchial and extrabronchial lesions.
【作者單位】： 新疆醫(yī)科大學(xué)一附院呼吸科;新疆醫(yī)科大學(xué)一附院老年病科;
【基金】：新疆維吾爾自治區(qū)自然科學(xué)基金(No:2015211C049)
【分類號】：R56;R734

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