超声支气管镜引导下经支气管针吸活检术136例临床应用分析  

The analysis of clinical application of endobronchial ultrasound-guided transbronchial needle aspiration in 136 cases

作　　者：张志远[1] 王敏[1] 王彦[1] 孙丽[1] 马壮[1] 

机构地区：[1]沈阳军区总医院呼吸科,沈阳110016

出　　处：《临床内科杂志》2014年第9期608-610,共3页Journal of Clinical Internal Medicine

摘　　要：目的 评价超声支气管镜引导下经支气管针吸活检术（EBUS-TBNA）对纵隔和肺门淋巴结肿大或支气管腔外肿物的诊断价值和安全性.方法 回顾性分析2011年5月～2013年7月于我院行EBUS-TBNA检查的136例患者临床资料.结果 共穿刺纵隔或肺门淋巴结185例次,腔外肿物44例次.病理学检查诊断为恶性肿瘤81例（64.3％）,良性疾病22例（17.5％）,可疑恶性疾病9例（7.1％）,病理结果无诊断意义14例（11.1％）,穿刺失败10例（7.3％）.恶性肿瘤中小细胞肺癌36例（44.4％）,非小细胞肺癌32例（39.5％）,恶性淋巴瘤1例（1.2％）,转移癌4例（4.9％）,无法分型者8例（9.9％）.良性疾病中肉芽肿性疾病16例（72.7％）,普通炎症2例（9.1％）,经抗酸染色直接明确诊断结核4例（18.2％）,肉芽肿性疾病中诊断结核3例（18.8％）,结节病11例（68.8％）,曲霉菌感染2例（12.5％）.EBUS-TBNA诊断恶性疾病的敏感度为90.0％,特异度为100％;诊断良性疾病的敏感度为37.5％,特异度为100％.所有患者术中术后均未发生严重并发症.结论 EBUS-TBNA对不明原因纵隔-肺门淋巴结肿大或气管/支气管腔外病变的诊断具有重要价值.Objective To evaluate the diagnostic value and the safety of endobronchial ultrasound-guided transbronchial needle aspiration （EBUS-TBNA） in mediastinal and hilar lymph nodes and lung tumors. Methods EBUS-TBNA was performed in 136 patients with thoracic masses or mediastinalhilar lymphoadenopathy proved by CT scan. Results From May 2011 to July 2013,136 patients were included in the study. EBUS-guided TBNA was performed to obtain samples from mediastinal and hilar lymph nodes（ 185 stations） and lung tumors（44 masses）. There were 81 cases（64.3% ） diagnosed cancer,22 cases（17.5% ）benign diseases, and 9 cases（7. 1% ） suspicious cance by pathological diagnosis. 14 cases＇ （11.1% ）pathological diagnosis cannot be definited though the biopsy were peffomed successfully, and 10 cases＇ （7.3 % ） biopsy were failure. In cancer cases,36 cases （44.4%）were small cell lung cancer, 32 cases （ 39.5 % ） non-small cell lung cancer, 1 case （ 1.2% ） malignant lymphoma ,4 cases （ 4.9% ） metastatic carcinoma,and 8 cases （9.9%） unclear type cancer. In benign disease cases, 16 cases（72.7% ） were granuloma,2 cases （9.1% ）lymphnoditis ,4 cases（ 18.2% ） lymphoid tuberculosis. In granuloma cases, 3 cases （ 18.8% ） were lymphnoditis, 11 eases （ 68.8 % ） sarcoidosis, 2 cases （ 12.5 % ） aspergillus infection. The sensitivity and specificity of EBUS-TBNA in the diagnosis of cancer was 90.0% and 100%. But in benign disease the sensitivity and specificity was 37.5% and 100%. There were no complications. Conclusion EBUS-TBNA is an effective and safe method for the diagnosis of unknown mediastinal-hilar lymphadenopathy and lung/mediastinum masses.

关 键 词：支气管镜检查 超声检查 介入性 活组织检查 

分 类 号：R734.2[医药卫生—肿瘤]