EBUS-TBNA对上腔静脉综合征诊断价值分析  

EBUS-TBNA for diagnosis of superior vena cava syndrome

作　　者：李士杰[1,2] 曹长琦[1,2] 闫炎[1,2] 张集昌[1,2] 李忠武[1,3] 吴齐[1,2] 

机构地区：[1]北京大学肿瘤医院 [2]北京市肿瘤防治研究所恶性肿瘤发病机制及转化研究教育部重点实验室内镜中心,北京100142 [3]北京市肿瘤防治研究所恶性肿瘤发病机制及转化研究教育部重点实验室病理科,北京100142

出　　处：《中华肿瘤防治杂志》2013年第10期768-771,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:探讨支气管内超声引导下经支气管针吸活检术(EBUS-TBNA)在上腔静脉综合征(SVCS)病因诊断中应用的可行性及价值。方法:选取接受EBUS-TBNA检查的17例初诊SVCS患者作为研究对象。采用Kishi评分系统评估其SVCS的严重程度。以最终病理诊断为金标准,结合其临床资料,对EBUS-TBNA在SVCS患者病因学诊断中的适用范围、效果及安全性做出评价。结果:17例患者共穿刺25个部位(包括右侧气管旁17个,隆突下5个,右侧肺门3个),各部位穿刺次数为1～3次,患者平均操作时间为(14.76±3.82)min。患者术前Kishi评分为2～6。术后30min时所有患者的Kishi评分与术前相同。16例(94.1%)通过EBUS-TBNA获得了恶性病理确诊,其中肺癌15例(88.2%),包括鳞癌2例,腺癌4例,小细胞癌9例;1例患者(5.9%)为无法确定来源的低分化癌。在EBUS-TBNA操作过程中,除3例(17.7%)患者需短暂提高吸氧流量外,未发生活动性出血、气胸等严重并发症。结论:对于SVCS患者,EBUS-TBNA可作为一种安全、可靠的微创病因诊断方法。OBJECTIVE： To evaluate the feasibility and efficacy of endobronchial ultrasound-guided transbronehial needle aspiration （EBUS-TBNA） in patients with superior vena eava syndrome （SVCS）. METHODS： Seventeen consecu- tive cases presented with SVCS were enrolled in this study. The severity of SVCS was graded with Kishi system. EBUS- TBNA was performed under local anesthesia. The clinical data and the final pathologic diagnosis of the 17 patients were e- valuated. RESULTS： Totally 25 procedures of EBUS-TBNA were performed in 17 patients （17 beside right windpipe, 5 under knuckle,3 at right hilus of the lung）. A median of 2 aspirations were done in each station （range 1-3）. The mean time of the procedures was （14.76~3.82） rain. According to the Kishi system,all the 17 patients scored from 2 to 6 be- fore EBUS-TBNA was performed. When the procedures were done only 3 patients showed slight score elevate, but re- stored quickly after a rest for 30 minutes. Malignancy was confirmed with EBUS-TBNA in 16 out of 17 （94.1 %） patients （including 9 small cell carcinoma, 4 adenocarcinoma, 2 squamous cell carcinoma and 1 poorly differentiated carcinoma） presented with SVCS,while one had a false negative result who required further mediastinoscopy. There was no major complication such as significant bleeding or pneumothorax related to the procedures,except temporarily increased oxygen supplement was needed in 3 （17.7%） patients. CONCLUSION： EBUS-TBNA can be a safe procedure with a high diag- nostic yield in SVCS patients.

关 键 词：上腔静脉综合征 支气管内超声引导下经支气管针吸活检术 肺癌 纵隔淋巴结肿大 

分 类 号：R730.4[医药卫生—肿瘤]