应用支气管内超声引导针吸活检术诊断胸部结节病  

Endobronchial ultrasound-guided transbronchial needle aspiration for the diagnosis of thoracic sarcoidosis

作　　者：赵辉[1] 王俊[1] 周足力[1] 李运[1] 杨德松[1] 隋锡朝[1] 陈克终[1] 李晓 李剑锋[1] 姜冠潮[1] 刘军[1] 

机构地区：[1]北京大学人民医院胸外科,100044

出　　处：《中华胸心血管外科杂志》2011年第9期529-531,538,共4页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：本课题受首都医学发展科研基金资助（2009-3032）

摘　　要：目的探讨支气管内超声引导针吸活检术（endobronchial ultrasound-guided transbronchial needle aspiration,EBUS-TSNA）诊断胸部结节病的价值。方法回顾性分析2009年9月至2011年6月接受EBUS—TBNA检查的35例临床拟诊胸部结节病患者的临床资料，所有患者术前胸部CT检查均发现肺门和（或）纵隔淋巴结肿大（≥1．0cm）。对于EBUS—TBNA未能明确诊断的患者，进一步接受外科手术活检或至少6个月以上的临床及影像学随访。结果35例患者，经EBUS-TBNA活检87组淋巴结，其中纵隔淋巴结64组，肺门及叶间淋巴结23组。最终明确诊断胸部结节病28例（80％），其中经EBUS—TBNA明确诊断25例（89．3％）。所有患者检查耐受良好，无任何相关并发症发生。结论EBUS—TBNA是一种安全有效的诊断方法，对于Ⅰ、Ⅱ期胸部结节病有较高的诊断率。Objective To evaluated the role of endobronchial uhrasound-guided transbronchial needle aspiration （EBUS-TBNA） in the diagnosis of thoracic sarcoidosis. Methods The study was retrospective, from September 2009 to June 2011, 35 patients with suspected sarcoidosis, with enlarged hilar or mediastinal lymph nodes on computed tomography （≥1.0 cm）, underwent EBUS-TBNA. Patients in whom EBUS-TBNA was nondiagnostic subsequently underwent surgical biopsy or a minimum of 6 months clinical and radiologic follow-up. Results EBUS-TBNA was performed on a total of 87 lymph node sta- tions in 35 patients. Of the enlarged lymph nodes, 64 （73.6%） were located in the mediastinal region and the remaining 23 （26.4%） around the hilar or interlobar area. A final diagnosis of sarcoidosis was made for 28 （80%） of the patients. In patients with a final diagnosis of sarcoidosis, EBUS-TBNA demonstrated noncaseating epithelioid cell granulomas in 25 （89.3%） of the patients. EBUS was well tolerated by all of the patients with no complications. Conclusion EBUS-TBNA is a safe procedure with a high yield for the diagnoses of thoracic sarcoidosis of stage Ⅰ or Ⅱ.

关 键 词：结节病 诊断 活组织检查 针吸 超声检查 介入性 

分 类 号：R56[医药卫生—呼吸系统]