EBUS-TBNA在肺和/或纵隔疾病中的诊断价值  

Diagnostic value of EBUS-TBNA in pulmonary and/or mediastinal diseases

作　　者：王步青[1] 文进[2] 何元兵[1] 齐曼古力.吾守尔 王晶[4] WANG Bu-qing;WEN Jin;HE Yuan-bing;QIMANGULI Wshou-er;WANG Jing(Department of Respiratory Medicine,the First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830054,China)

机构地区：[1]新疆医科大学第一附属医院呼吸科,新疆乌鲁木齐830054 [2]新疆医科大学第二附属医院呼吸科,新疆乌鲁木齐830054 [3]新疆医科大学第一附属医院昌吉分院,新疆昌吉市831100 [4]新疆医科大学第一附属医院老年病科,新疆乌鲁木齐830054

出　　处：《临床肺科杂志》2018年第4期644-648,共5页Journal of Clinical Pulmonary Medicine

基　　金：新疆维吾尔自治区重大科技专项(No 2017A03006-2)

摘　　要：目的探讨超声内镜引导下支气管针吸活检在肺和/或纵隔疾病的诊断价值。方法回顾性分析新疆医科大学第一附属医院2014年01月-2017年06月接受超声内镜引导下支气管针吸活检(EBUSTBNA)或传统支气管针吸活检(c TBNA)检查的142例患者的医疗记录,对两组患者的病理学检查结果、阳性率、灵敏度、特异度、准确度、阳性预测值、阴性预测值进行统计分析。结果 EBUS-TBNA组77例患者共穿刺158组淋巴结,c TBNA组65例患者共穿刺134组淋巴结,EBUS-TBNA组的阳性率、灵敏度、特异度、准确度、阳性预测值、阴性预测值为:65.8%、86.1%、100%、87.0%、100%、33.3%,c TBNA组的阳性率、灵敏度、特异度、准确度、阳性预测值、阴性预测值为:41.8%、60.7%、100%、63.1%、100%、14.3%;两组患者对检查的耐受性均较好,未出现严重并发症;对影响病理阳性的因素行Logistic回归分析,发现病灶越大病理阳性率越高,穿刺次数越多,病理阳性率越高,EBUS-TBNA组较c TBNA组病理阳性率高。结论 EBUS-TBNA具有较高的诊断阳性率、灵敏度以及准确度,且未增加相关并发症,在肺和/或纵隔疾病诊断中具有更高的价值。Objective To determine the value of endobronchial ultrasound-guided transbronchial needle aspiration(EBUS-TBNA)in the diagnosis of pulmonary and/or mediastinal diseases.Methods The clinical data of 142 patients who underwent EBUS-TBNA or cTBNA from January 2014 to June 2017 were retrospectively reviewed.The pathological results,diagnostic yield,sensitivity,specificity,positive predictive value,negative predictive value and accuracy of this procedure were statistical analysis.Results EBUS-TBNA from 77 patients was successfully performed to obtain samples from 158 stations of lymph nodes,and the diagnostic yield,sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 65.8%,86.1%,100%,87.0%,100%and 33.3%,respectively.cTBNA from 65 patients was successfully performed to obtain samples from 134 stations of lymph nodes,and the diagnostic yield,sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 41.8%,60.7%,100%,63.1%,100%and 14.3%,respectively.All patients had no serious complications.Multivariate logistic regression analysis showed that lesion short diameter,puncture times and the types of puncture were the independent predictive factors of pathological positive incidence.Conclusion EBUS-TBNA has higher sensitivity,specificity and accuracy in diagnosis of pulmonary and/or mediastinal diseases,with no related complications increased.

关 键 词：传统支气管针吸活检(cTBNA) 超声内镜引导下支气管针吸活检(EBUS-TBNA) 肺和/或纵隔疾病 

分 类 号：R56[医药卫生—呼吸系统]