EBUS-TBNA在上腔静脉阻塞综合征诊断中的临床应用  

Clinical Application of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration Biopsy for the Diagnosis of Superior Vena Cava Obstruction Syndrome

作　　者：华胸怀[1] 张玮[1] 冯惠民[2] 魏秀峰[1] 乔思杰 李印[1] 

机构地区：[1]河南省肿瘤医院胸外科,郑州450008 [2]河南省肿瘤医院麻醉科,郑州450008 [3]河南省军区医院病理科,郑州450014

出　　处：《中国肺癌杂志》2013年第9期482-486,共5页Chinese Journal of Lung Cancer

摘　　要：背景与目的纵隔淋巴瘤或右上肺癌是导致上腔静脉阻塞综合征(superior vena cava obstruction syndrome,SVCOS)的常见病因。气管腔内超声引导针吸活检术(endobronchial ultrasound-guided transbronchial needle aspiration,EBUS-TBNA)在纵隔占位疾病的诊断方面,与外科手术相当。本研究旨在探讨全麻状态下EBUS-TBNA在SVCOS临床病因诊断中的安全性及可行性。方法 2012年6月-2013年6月25例伴有SVCOS全麻状态下接受EBUS-TBNA的患者,其中男16例,女9例;年龄33岁-76岁,中位62.5岁。结果 24例病理学证实为恶性肿瘤,确诊率为96.0%(24/25),1例未能获得明确病理诊断;所有患者均未出现与操作相关的并发症,包括大量出血与气胸。结论对伴有SVCOS的患者,全麻状态下EBUS-TBNA仍是一种确诊率高、安全可靠的微创检查方法,可作为其他手段不能明确病理诊断的常规检查。Background and objective Mediastinal lymphoma or right upper lung cancer is a common cause of superior vena cava obstruction syndrome（SVCOS）.Endobronchial ultrasound-guided needle aspiration（EBUS-TBNA） biopsy is applied for the diagnosis of mediastinal mass disease.The aim of this study is to explore the safety and feasibility of EBUS-TBNA biopsy under general anesthesia for the clinical diagnosis of SVCOS.Methods Twenty-five cases of SVCOS received EBUS-TBNA under general anesthesia between June 2012 and June 2013.The group consisted of 16 male and 9 female patients aged 33 years to 76 years,with a median age of 62.5.Results Twenty-four cases were confirmed to be of malignant pathology,and one case failed to yield a clear pathological diagnosis.No patient experienced any complications related to the operation,such as heavy bleeding and pneumothorax.Conclusion For patients presenting with SVCOS,EBUS-TBNA under general anesthesia is a safe and reliable inspection method of high diagnostic yield.This method can be used for routine examination when other means cannot obtain clear pathological diagnosis.

关 键 词：气管腔内超声引导针吸活检术 上腔静脉阻塞综合征 临床应用 

分 类 号：R734[医药卫生—肿瘤]