支气管超声在肺外周占位性病变诊断中的应用价值  

A study of the diagnostic value of endobronchial ultrasound transbronchial lung biopsy in pulmonary peripheral occupying lesion

作　　者：何正强[1] 吴迪[1] 金常娥[1] 王苑玲[1] 李秀媚[1] HE Zheng-qiang;WU Di;JIN Chang-e(Department of Respiratory Disease,She~zzhen People＇s Hospital and the Second Clinical Medical College,Ji＇nan University,She~zzhen 518020,China)

机构地区：[1]暨南大学第二临床医学院深圳市人民医院呼吸科,广东深圳518020

出　　处：《吉林医学》2018年第6期1042-1045,共4页Jilin Medical Journal

摘　　要：目的:探讨支气管超声引导经支气管透壁肺活检术(EBUS-TBLB)在肺外周占位性病变的诊断价值。方法:回顾性分析85例传统经支气管透壁肺活检术(TBLB)和97例EBUS-TBLB检查患者的临床资料,评估传统TBLB和EBUS-TBLB的诊断率,同时比较占位性病变直径大小病灶、不同超声探头与病灶位置关系时两种方法的诊断率。结果:97例患者通过EBUS-TBLB确诊75例,诊断率为77.32%,85例患者通过传统TBLB确诊57例,诊断率为67.06%,两组比较差异无统计学意义(P>0.05)。EBUS-TBLB组和TBLB组在直径>30 mm的病灶诊断率分别为82.46%和80.39%,两组比较差异无统计学意义(P>0.05),而在≤30 mm的病灶,EBUS-TBLB组和TBLB组的诊断率为70.00%和47.06%,差异有统计学意义(P<0.05);EBUS-TBLB组和TBLB组在直径为≤30 mm并且>20 mm的诊断率为77.78%和50.00%,差异有统计学意义(P<0.05),但在直径≤20 mm的病灶诊断率比较差异无统计学意义(P>0.05)。在EBUS-TBLB组,根据超声探头与病灶的关系,病灶包绕超声探头的诊断率为86.76%,病灶边缘临近超声探头的诊断率为55.17%,两组比较差异有统计学意义(P<0.05)。结论:EBUS-TBLB是一种安全有效的诊断方法,EBUS可提高直径≤30 mm的病灶TBLB的诊断率,超声探头和病灶的位置关系可影响EBUS-TBLB诊断率。Objective To evaluate the diagnostic value of endobronchial ultrasound-guided transbronchial lung biopsy（ EBUS-TBLB） in the diagnosis of peripheral pulmonary occupying lesion. Method The clinical data of 85 patients undergoing conventional TBLB and 97 patients undergoing EBUS-TBLB for peripheral pulmonary occupying lesion were retrospectively analyzed,compared the diagnostic rate between the two methods,andanalys the impact to the diagnostic rate in different diameters,and the position relation between lesion location and acoustic probe. Results The diagnostic rate of EBUS-TBLB for peripheral pulmonary occupying lesion was 77. 32%,and that of conventional TBLB was 67. 06%,the difference between the two groups was not statistically significant（ P〈0.05）. For lesions larger than 30 mm,the diagnostic rate of EBUS-TBLB was 82. 46%,and that of conventional TBLB was 80. 39%,the difference was not statistically significant（ P〈0.05）. For lesions diameter less than or equal to 30 mm lesions,the diagnosis rate of EBUS-TBLB and conventional TBLB respectively were 70. 00% and 47. 06%,the difference was statistically significant（ P〈0.05）. For lesions diameter less than or equal to 30 mm and greater than 20 mm,the diagnosis rate of EBUS-TBLB and conventional TBLB respectively were 77. 78% and 50. 00%,the difference was statistically significant（ P〈0.05）. But for lesions less than or equal to 20 mm,the diagnosis rate of EBUS-TBLB and conventional TBLB were no statistically significant difference（ P〈0.05）; In group EBUS-TBLB,if lesions around the ultrasound probe,the diagnosis rate was 86. 76%,higher than that of the ultrasonic probe near the edge of lesions（ 55. 17%）,the difference was statistically significant（ P〈0.05）. Conclusion EBUS-TBLB is a safe and effective diagnostic method. EBUS can improve the diagnostic rate of TBLB for peripheral pulmonary occupying lesion with diameter less than or equal to 30 mm. The positional relationship of the probe and the lesion can influence the d

关 键 词：肺外周占位性病变 支气管超声 经支气管透壁肺活检术 

分 类 号：R445.1[医药卫生—影像医学与核医学] R563[医药卫生—诊断学]