支气管内超声引导针吸活检术（EBUS-TBNA）在胸内淋巴结结核诊断中的应用价值  

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

作　　者：解桢[1] 赵辉[1] 郑红芳[2] 沈丹华[2] 王俊[1] 

机构地区：[1]北京大学人民医院胸外科,100044 [2]北京大学人民医院病理科,100044

出　　处：《中华胸心血管外科杂志》2013年第12期739-742,共4页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：首都医学发展科研基金（2009-3032）

摘　　要：目的探讨支气管内超声引导针吸活检术（EBUS—TBNA）在胸内淋巴结结核诊断中的应用价值。方法回顾性总结2009年9月至2012年9月接受EBUS—TBNA检查并最终明确诊断为胸内淋巴结结核的38例患者临床资料。患者术前胸部增强CT检查均发现肺门和（或）纵隔淋巴结肿大（≥10mm），对于EBUS—TBNA未能明确诊断的患者，进一步接受外科手术活检。术后均接受至少6个月以上的临床及影像学随诊。结果38例患者经EBUS—TBNA活检88组淋巴结，其中纵隔淋巴结60组（68．18％），肺门及叶间淋巴结28组（31．82％）。38例患者中经EBUS—TBNA明确诊断34例（89．47％）。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，对于胸部淋巴结结核有较高的诊断率。Objective To evaluated the role of endobronchial ultrasound-guided transbronchial needle aspiration （ EBUSTBNA） in the diagnosis of thoracic tuberculosis. Methods The study was retrospective, from September 2009 to September 2012, 38 patients who underwent EBUS-TBNA were finally diagnosed of thoracic tuberculosis, with enlarged hilar or mediastihal lymph nodes on chest enhanced computed tomography（ ≥1.0 cm）. Patients in whom EBUS-TBNA was nondiagnoslic sub- sequently underwent surgical biopsy. All the patients had a minimum of 6 months clinical and radiologic follow-up. Results EBUS-TBNA was performed on a total of 88 lymph node stations in 38 patients. Of the enlarged lymph nodes, 60 （68.18%） were located in the mediastinal region and the remaining 28 （31.82% ） around the hilum or interlobar area. Of the 38 patients, EBUS-TBNA achieved definitive diagnosis in 34 patients （89.47%）. 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 tuberculosis.

关 键 词：结核 支气管内超声 经支气管针吸活检 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]