虚拟支气管镜导航在无症状浸润型肺结核诊断中的应用价值  

Value of VBN in the Diagnosis of Asymptomatic Infiltrating Pulmonary Tuberculosis

作　　者：李玲 王涛 陈红兵 LI Ling;WANG Tao;CHEN Hongbing(The Fourth Ward of Tuberculosis Department,The Eighth Medical Center of PLA General Hospital,Beijing 100091,China)

机构地区：[1]中国人民解放军总医院第八医学中心结核科四病区,北京100091

出　　处：《中国医疗设备》2022年第5期15-18,共4页China Medical Devices

基　　金：“十三五”国家科技重大专项(2018ZX10725509)。

摘　　要：目的观察虚拟支气管镜导航技术在无症状浸润型肺结核早期诊断中的价值。方法采用前瞻性研究的方法,选择于2016年5月至2020年12月因肺部病灶怀疑肺结核就诊于本科室的无症状患者,临床初诊为疑似病例并最终诊断为肺结核的患者,随机分为电子支气管镜检查(Electronic Bronchoscopy,EOB)组和虚拟支气管镜导航(Virtual Bronchoscopic Navigation,VBN)+EOB组,比较灌洗液阳性、支气管镜检查时间、气管镜到达病灶支气管使用时间的差异。结果支气管镜检查时间比较上,VBN+EOB组优于EOB组,差别具有统计学意义(t=1.384,P=0.026),在到达病灶支气管位置的时间比较上,VBN+EOB组也明显优于单纯EOB组,差异具有统计学意义(t=18.269,P<0.001)。但在涂片抗酸染色、分枝杆菌分离培养、结核分枝杆菌核酸检测、结核分枝杆菌复合群双基因检测四个项目阳性率上,VBN组及VBN联合EOB组差别均无统计学意义(P>0.05)。结论虚拟支气管镜导航联合常规支气管镜肺泡灌洗在诊断率上对比单纯支气管镜肺泡灌洗并无明显优势,但可显著缩短支气管镜检查时间,减少患者主观不适感,具有临床应用价值。Objective To observe the value of virtual bronchoscopy navigation(VBN)in the early diagnosis of asymptomatic infiltrating tuberculosis.Methods Using prospective research methods,asymptomatic patients with pulmonary lesions suspected of pulmonary tuberculosis admitted to our department from May 2016 to December 2020 were selected,who were initially clinically diagnosed as suspected cases,and finally diagnosed with tuberculosis.They were randomly divided into electronic bronchoscopy(EOB)group and VBN+EOB group.The positive and negative rates of lavage fluid,bronchoscopy examination time,and use time of bronchoscope to the lesion were compared.Results The comparison of bronchoscopy examination time in the VBN+EOB group was significantly better than that in the EOB group(t=1.384,P=0.026).The comparison of use time of bronchoscope to the lesion in the VBN+EOB group was also significantly better than that in the simple EOB group(t=18.269,P<0.001).However,there was no statistically significant difference in the positive rates of the four items of smear acid-fast staining,mycobacterial isolation and culture,mycobacterium tuberculosis nucleic acid detection,and mycobacterium tuberculosis coincident group doublegene detection(P>0.05).Conclusion VBN combined with conventional bronchoscopic alveolar lavage has no obvious advantage in diagnosis rate compared with simple bronchoscopic alveolar lavage,but it can significantly shorten the bronchoscopy examination time,reduce the subjective discomfort of patients,and has clinical application value.

关 键 词：虚拟支气管镜导航 电子支气管镜检查 无症状浸润型肺结核 诊断率 

分 类 号：R197.39[医药卫生—卫生事业管理]