快速现场评价联合径向支气管内超声在经支气管冷冻活检诊断弥漫性肺疾病中的应用  

Application of rapid on-site evaluation combined with radial-endobronchial ultrasound of transbronchial cryobiopsy in the diagnosis of diffuse lung diseases

作　　者：陈伟庄 李优 王辉[1] 周莹艳[1] 王国安[1] 沈世茉[1] 陈金平 吴仕波[1] 吴宏成[1] CHEN Weizhuang;LI You;WANG Hui;ZHOU Yingyan;WANG Guoan;SHEN Shimo;CHEN Jinping;WU Shibo;WU Hongcheng(Department of Pulmonary and Critical Care Medicine,Ningbo Medical Treatment Center Li Huili Hospital,Ningbo 315040,China;Ningbo Diagnostic Pathology Center,Ningbo 315021,China)

机构地区：[1]宁波市医疗中心李惠利医院呼吸与危重症医学科,浙江宁波315040 [2]宁波市临床病理诊断中心,浙江宁波315021

出　　处：《温州医科大学学报》2022年第2期132-138,共7页Journal of Wenzhou Medical University

摘　　要：目的:探讨在快速现场评价(ROSE)与径向支气管内超声(R-EBUS)辅助下经支气管冷冻活检(TBCB)在弥漫性肺疾病(DLD)诊断中的可行性和安全性。方法:收集2019年6月至2021年9月宁波市医疗中心李惠利医院行TBCB的DLD患者,记录临床特征、病理类型、活检特征和并发症,分析TBCB在DLD诊断中的可行性和安全性。结果:共收集52例患者,其中男20例,女32例,年龄(54.0±13.2)岁;总共活检182次,人均(3.50±1.00)次;标本大小6~30 mm^(2),平均(13.69±4.72)mm^(2)。参照2013美国胸科学会/欧洲呼吸病学会对间质性肺疾病分类标准,已知病因26例(50.00%),特发性间质性肺炎13例(25.00%);肉芽肿性病变4例(7.69%),其他类型9例(17.31%)。在并发症方面,没有或极少量出血20例,轻度出血21例,中度出血11例,重度出血0例;气胸2例。急性左心衰1例,低氧血症1例。术后中位住院时间6(1.00,6.00)d。结论:联合应用ROSE与R-EBUS于TBCB在DLD诊断中具有一定的可行性和安全性。Objective:To investigate the feasibility and safety of transbronchial cryobiopsy(TBCB)in the diagnosis of diffuse lung diseases(DLD)with assistance of Rapid On-Site Evaluation(ROSE)and Radial-endobronchial ultrasound(R-EBUS).Methods:Patients with diffuse lung disease who underwent TBCB from June 2019 to September 2021 were enrolled and their clinical characteristics,pathological types,biopsy characteristics and complications were recorded.Results:A total of 52 patients were included in the study,20 males and 32 females,with a mean age of(54.0±13.2)years;a total of 182 cryobiopsies,(3.50±1.00)cryobiopsies per patient;the mean size of tissues was(13.69±4.72)mm^(2),ranging 6-30 mm^(2).According to the 2013 ATS/ERS classification standard for the interstitial lung diseases,there were 26 cases of known etiology(50.00%),13 cases of idiopathic interstitial pneumonia(25.00%),4 case of granulomatous lesions(7.69%)and 9 cases of other types(17.31%).In terms of complications,none or minimal bleeding occurred in 20 patients,mild bleeding in 21 patients,moderate bleeding in 11 patients.No severe bleeding occurred.Pneumothorax occurred in 2 patients,acute left heart failure in 1 patient and hypoxemia in 1 patient.The median post-TBCB hospital day was 6(1.00,6.00)days.Conclusion:The combined application of ROSE and R-EBUS in TBCB is feasible and safe in the diagnosis of DLD.

关 键 词：快速现场评估 径向支气管内超声 经支气管冷冻活检 弥漫性肺疾病 出血风险 

分 类 号：R563[医药卫生—呼吸系统]