肺部周围性病变诊断中经纤支镜肺活检的应用及确诊率的影响  

Application of bronchofibroscope lung biopsy in the diagnosis of pulmonary peripheral lesions and influence on diagnosis rate

作　　者：张沛聪 黄增龙 Zhang Peicong;Huang Zenglong(Department of Internal Medicine,Shawan People's Hospital of Panyu District,Guangzhou City,Guangdong Guangzhou 511483;Department of Respiratory Medicine,Hexian Memorial Hospital of Panyu District,Guangzhou City(The Maternal and Child Health Hospital of Panyu District,Guangzhou City),Guangdong Guangzhou 511400)

机构地区：[1]广州市番禺区沙湾人民医院内科,广东广州511483 [2]广州市番禺区何贤纪念医院(广州市番禺区妇幼保健院)呼吸内科,广东广州511400

出　　处：《中国社区医师》2020年第36期118-119,共2页Chinese Community Doctors

摘　　要：目的:探讨肺部周围性病变诊断中经纤支镜肺活检的应用及对确诊率的影响。方法:选取2018年12月-2020年1月使用常规纤支镜检查无异常的肺部周围性病变患者68例,使用CT片或者胸片进行定位,在无X线引导下进行经纤支镜肺活检。结果:经纤支镜肺活检对肿块性病灶的确诊率为69.2%,浸润性病灶为79.4%,弥漫性病变为81.0%;病灶直径2.0~3.0 cm确诊率为69.2%,3.1~4.0 cm确诊率为77.8%,4.1~5.0 cm确诊率为88.9%,5.1~6.0 cm确诊率为85.7%,>6.0 cm确诊率为75.0%;手术后,大多数患者发生短暂的痰中带血;术后发生小量咯血6例,气胸3例,发热5例,其中需要抽气引流1例。结论:肺部周围性病变诊断中,经纤支镜肺活检的效果比较理想,可以提高确诊率,促使患者得到更多的及时治疗。Objective:To explore the application of bronchofibroscope lung biopsy in the diagnosis of pulmonary peripheral lesions and influence on diagnosis rate.Methods:From December 2018 to January 2020,68 cases of peripheral pulmonary lesions without abnormality by routine bronchoscopy were selected,CT or chest X-ray were used for localization,and transbronchoscopic lung biopsy was performed without X-ray guidance.Results:The diagnostic rate of transbronchoscopic lung biopsy was 69.2% for mass lesions,79.4% for invasive lesions and 81.0% for diffuse lesions.The diagnostic rate of lesions with diameter of 2.0~3.0 cm was 69.2%,that of 3.1~4.0 cm was 77.8%,that of 4.1~5.0 cm was 88.9%,that of 5.1~6.0 cm was 85.7%,and that of>6.0 cm was 75.0%.After the operation,most of the patients had transient blood in sputum.After operation,there were 6 cases of small amount of hemoptysis,3 cases of pneumothorax and 5 cases of fever,one case needed air drainage.Conclusion:In the diagnosis of pulmonary peripheral lesions,the effect of bronchofibroscope lung biopsy is ideal,which can improve the diagnosis rate and promote patients to get more timely treatment.

关 键 词：肺部周围性病变 经纤支镜肺活检 确诊率 CT片 

分 类 号：R563[医药卫生—呼吸系统]