电视纵隔镜与支气管内超声引导针吸活检术诊断纵隔肿物价值  

Diagnostic value of TV mediastinum( VAM) and endobronchial ultrasound guided needle aspiration( EBUS-TBNA) for mediastinal mass

作　　者：徐先全 吕莉萍 徐建平 方雪晖 王起奎 陆海霞 XU Xian-quan;LV Li-ping;XU Jian-ping;FANG Xue-hui;WANG Qi-kui;LU Hai-xia(Department of Cardiothoracic Surgery, Anhui Chest Hospital, Hefei, Anhui 230022, China)

机构地区：[1]安徽省胸科医院心胸外科,安徽合肥230022

出　　处：《临床肺科杂志》2019年第1期30-33,共4页Journal of Clinical Pulmonary Medicine

基　　金：安徽省卫计委课题(No 15tb007)

摘　　要：目的比较电视纵隔镜(VAM)与支气管内超声引导针吸活检术(EBUS-TBNA)对纵隔肿物的诊断价值。方法选择我院胸外科胸部CT检查拟诊纵隔肿物(肿物短径大于1. 0cm),需要进一步明确诊断的126例住院患者分别行VAM、EBUS-TBNA。VAM组:75例; EBUS-TBNA组:51例。根据术后石蜡切片病理结果及随访,分别计算两种方法的准确性、灵敏度、特异度。结果 VAM诊断纵隔肿物的准确性94. 67%,灵敏度94. 12%,特异度100%; EBUS-TBNA诊断纵隔肿物的准确性88. 24%,灵敏度87. 50%,特异度100%。结论在纵隔肿物诊断方面,VAM和EBUS-TBNA均是有效的方法。从创伤、并发症、伦理等因素综合考虑,建议首先EBUS-TBNA。对于纵隔良性病变及淋巴瘤VAM可能具有更高的诊断价值;对于合并有肺门或邻近气管、支气管肺内肿物的患者,EBUS-TBNA在疾病诊断方面具有更明显的优势。Objective To compare the diagnostic value of TV mediastinum(VAM)and endobronchial ultrasound guided needle aspiration(EBUS-TBNA)for mediastinal mass.Methods 126 cases of hospitalized patients with short diameter of the tumor greater than 1.0cm from the department of thoracic surgery were given VAM and EBUS-TBNA to make further clear diagnosis when they were initially diagnosed as mediastinal mass through CT examination.There were 75 cases in the VAM group and 51 cases in the Ebus-tbna group.The accuracy,sensitivity,specificity of the two methods were calculated according to the pathological results and follow-up.Results The accuracy of VAM in the diagnosis of mediastinal mass was 94.67%,its sensitivity was 94.12% and its specificity was 100%.The accuracy of EBUS-TBNA was 88.24%,its sensitivity was 87.50%,and specificity was 100%.Conclusion Both VAM and EBUS-TBNA are effective methods in the diagnosis of mediastinal mass.EBUS-TBNA is recommended for the combination of trauma,complications and ethics.VAM may have higher diagnostic value for mediastinal benign lesions and lymphoma.EBUS-TBNA has more obvious advantages in the diagnosis of disease in patients with lung or adjacent trachea and bronchus mass.

关 键 词：电视纵隔镜 支气管内超声引导针吸活检术 纵隔肿物 诊断价值 

分 类 号：R564[医药卫生—呼吸系统]