不同直径探针在经支气管冷冻肺活检诊断弥漫性肺疾病中的应用价值  

Efficacy and safety of different diameter probes in diagnosis of diffuse lung disease by transbronchial cryobiopsy

作　　者：唐飞 吕莉萍 程宇 吴迎凤 赵洁婷 叶伟 徐建平 徐栗 TANG Fei;LYU Liping;CHENG Yu;WU Yingfeng;ZHAO Jieting;YE Wei;XU Jianping;XU Li(Department of Endoscopic Diagnosis and Treatment Center,Hefei 230022,China;Department of Pathology,Anhui Chest Hospital,Hefei 230022,China;Department of Respiratory Endoscopy,Shandong Chest Hospital,Jinan 250013,China)

机构地区：[1]安徽省胸科医院内镜诊疗中心、介入肺脏病科,安徽合肥230022 [2]安徽省胸科医院内镜诊疗中心、介入病理科,安徽合肥230022 [3]山东省胸科医院呼吸内镜科,山东济南250013

出　　处：《安徽医学》2022年第7期753-757,共5页Anhui Medical Journal

基　　金：安徽省胸科医院科研项目(项目编号:2020KJ013B);安徽省第一批适宜技术推广项目(项目编号:2016-RK07)。

摘　　要：目的评价不同直径的冷冻探针行经支气管冷冻肺活检(TBCB)诊断弥漫性肺疾病的有效性和安全性。方法选择2019年1月至2021年6月因胸部CT提示为弥漫性肺疾病就诊安徽省胸科医院和山东省胸科医院共43例,行TBCB检查且临床资料完整的患者为研究对象,根据使用探针直径分为1.9 mm组和2.4 mm组,回顾性分析两组患者的一般临床资料,并就TBCB取得标本的大小、病理结果及相关并发症等进行比较。结果1.9 mm组共23例患者,获取TBCB组织样本105个,平均直径(4.68±1.42)mm,发生气胸3例,发生中度出血3例;2.4 mm组共20例患者,获取TBCB组织样本89个,平均直径(5.10±1.22)mm,发生气胸9例,发生中度出血8例;两组患者标本直径大小、气胸及中度出血的发生率以及手术操作时间比较,差异均有统计学意义(P<0.05)。43例患者中93%的患者均通过TBCB取得病理组织后明确诊断,且两组诊断率比较,差异无统计学意义(P>0.05)。结论TBCB两种直径的探针在弥漫性肺疾病的取材中均安全有效,其中1.9 mm的探针较2.4 mm探针并发症更少、操作时间更短,值得临床推广。Objective To evaluate the efficacy and safety of transbronchial cryobiopsy(TBCB)using cryoprobes of different diameters in the diagnosis of diffuse lung disease.Methods From January 2019 to June 2021,a total of 43 patients with TBCB examination and complete clinical data in Anhui Chest Hospital and Shandong Chest Hospital who were diagnosed with diffuse lung disease due to chest CT were selected as the research subjects.For the 1.9mm group and the 2.4mm group,the general clinical data of the two groups of patients were retrospectively analyzed,and the size of the TBCB specimens,pathological results and related complications were compared.Results A total of 23 patients underwent biopsy with a 1.9mm probe,105 TBCB tissue samples were obtained with an average diameter of(4.68±1.42)mm,3 patients had pneumothorax and 3 patients had moderate bleeding;a total of 20 patients underwent biopsy with a 2.4mm probe 89 TBCB tissue samples were obtained from the patients,with an average diameter of(5.10±1.22)mm,9 cases of pneumothorax and 8 cases of moderate bleeding;the two groups were different in the size of the specimen,the incidence of pneumothorax and moderate bleeding,and the operation time.All aspects were statistically significant(P<0.05).In addition,more than 93%of the patients in this study obtained a definite diagnosis afte r obtaining pathological tissue through TBCB,and there was no significant difference in the diagnosis rate between the two groups(P>0.05).Conclusions TBCB probes with two diameters are safe and effective in the sampling of diffuse lung disease,and the 1.9mm probe has fewer complications and shorter operation time than the 2.4mm probedoes,which is worthy of clinical promotion.

关 键 词：冷冻肺活检 弥漫性肺疾病 有效性 安全性 直径 

分 类 号：R563[医药卫生—呼吸系统]