超声支气管镜引导下支气管针吸活检在肺癌及纵隔肺门病变诊断中的应用价值  

Application value of needle aspiration biopsy guided by ultrasound in the diagnosis of lung cancer and mediastinal lung disease

作　　者：任丽娜[1] 刘春芳[1] 徐健[1] 庚俐莉[1] 高娜[1] 王维学[2] 

机构地区：[1]大连医科大学附属大连市中心医院呼吸科,大连116033 [2]大连医科大学附属大连市中心医院麻醉科,大连116033

出　　处：《中国肿瘤临床与康复》2016年第1期63-65,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨超声支气管镜引导下支气管针吸活检在肺癌及纵隔、肺门病变诊断中的应用价值。方法选择2012年8月至2014年10月间收治的140例肺部病变患者,计算机断层扫描(CT)检查均提示肺内病变伴纵隔和(或)肺门淋巴结肿大、不明原因的纵隔和(或)肺门淋巴结肿大以及纵隔占位病变,收集超声支气管镜引导下支气管针吸活检资料进行分析,并以手术病理证实结果作为诊断金标准,分析超声支气管镜引导下支气管针吸活检的准确率和超声结果以及并发症。结果 140例患者穿刺均为阳性,穿刺阳性率达到100.0%。126例取得阳性病理诊断,14例不确定,阳性诊断率为90.0%。肺内病变伴纵隔和(或)肺门淋巴结肿大87例,不明原因纵隔和(或)肺门淋巴结肿大45例,不明原因纵隔占位8例。140例穿刺患者未见大出血和气胸以及纵隔气肿等并发症。纵隔与肺门肿大淋巴结超声检查示圆形或椭圆形,多个病灶融合为不规则形状,病变内见低回声和局部回声加强以及回声不均匀,部分病变彩色多普勒超声显示血流信号;结节病超声检查发现上皮样细胞团、纤维丝样的改变;纵隔与肺门位置血管超声显示圆形或者管状,无回声区,彩色多普勒超声显示红色高能量信号。结论肺癌及纵隔、肺门病变患者应用超声支气管镜引导下支气管针吸活检检查具有较高诊断率,安全性高,是一种有效的诊断方法。Objective To evaluate the application value of needle aspiration biopsy guided by ultrasound in the diagnosis of lung cancer and mediastinal lung disease. Methods The datas of 140 cases who received needle aspiration biopsy guided by ultrasound between August 2012 and October 2014 were retrospective analyzed. Results The group of 140 cases of patients with biopsy-positive 140 cases,biopsy positive rate of 100. 0 %,and achieved positive pathological diagnosis 126 cases,14 cases of uncertainty,the positive diagnosis rate was 90. 0%. Lung disease with mediastinal and 87 cases of hilar lymph nodes,unexplained mediastinal and 45 cases of hilar lymph nodes,unexplained mediastinal space-occupying eight cases. 140 cases of patients with no bleeding puncture and pneumothorax and mediastinal emphysema and other complications. Mediastinal and hilar lymph nodes ultrasound examination revealed： round or oval,multiple lesions merge into irregular shapes,see hypoechoic lesion and strengthen local echo and echo uneven,some lesions color Doppler ultrasound showed the blood flow signal; sarcoidosis ultrasound examination revealed epithelioid cell clusters,filaments kind of change; mediastinal and hilar location intravascular ultrasound display： circular or tubular,echo-free zone,red color Doppler ultrasound showed high energy signal. Conclusion For lung and mediastinum,lung lesions patients,needle aspiration biopsy guided by ultrasound has high diagnostic rate,and its safety is high,which is an effective diagnostic method.

关 键 词：肺肿瘤 肺门病变 超声支气管镜 支气管针吸活检 诊断 

分 类 号：R734.2[医药卫生—肿瘤]