经超声支气管镜针吸活检在老年纵隔及肺门病变中的诊断价值及安全性  

Diagnostic value and safety of endobronchial ultrasound‐guided transbronchial needle aspiration for the elderly patients with mediastinal and hilar diseases

作　　者：杨建明 杨华 陈毅斐[2] 李俊[2] 赵欢欢[2] 程真顺[2] 刘冰[2] YANG Jianming;YANG Hua;CHEN Yifei;LI Jun;ZHAO Huanhuan;CHENG Zhenshun;LIU Bing(Dept.of Respiratory,Wuxue No.1 People's Hospital,Wuxue 435400,Hubei,China;Dept.of Respiratory and Critical Care Medicine,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China)

机构地区：[1]武穴市第一人民医院呼吸内科,湖北武穴435400 [2]武汉大学中南医院呼吸与危重症医学科,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2022年第6期997-1000,共4页Medical Journal of Wuhan University

基　　金：武汉大学中南医院培育项目(编号:znpy2018107)。

摘　　要：目的:研究经超声支气管镜针吸活检(EBUS⁃TBNA)在老年纵隔及肺门病变中的诊断价值和安全性。方法:回顾分析武汉大学中南医院2017年1月至2021年4月52例纵隔、肺门淋巴结肿大或肺部占位病变并行EBUS⁃TBNA的老年患者(年龄在70岁及70岁及以上)的临床资料,并选取同期的年龄小于70岁的248例患者作为对照,统计分析EBUS⁃TBNA在老年患者诊断中的诊断价值及安全性。结果:52例70岁及以上的患者中,平均年龄为(75.2±4.0)岁,男性占76.9%,高血压、冠心病、慢性阻塞性肺疾病(COPD)和糖尿病的合并症比例分别为17.3%、13.4%、30.8%和9.6%,其中COPD患者的比例明显高于70岁以下的患者(16/36 vs 31/248,P<0.01)。EBUS⁃TBNA在70岁及以上的老年患者诊断的的敏感度为95.3%、特异度为100%;在安全性方面,52例老年患者中,穿刺点出血2例,一过性低血压2例,一过性心律失常4例,一过性低氧血症10例,二氧化碳升高4例,与70岁以下的患者相比,差异无统计学意义。结论:经超声支气管镜针吸活检在老年纵隔及肺部疾病中,具有良好的诊断价值和安全性。Objective:To study the diagnostic value and safety of endobronchial ultrasound⁃guided trans⁃bronchial needle aspiration(EBUS⁃TBNA)in the diagnosis of mediastinal and hilar diseases of the el⁃derly.Methods:A retrospective analysis of the clinical data of 52 elderly patients(≥70 years,the el⁃derly group)with mediastinal or hilar diseases who underwent EBUS⁃TBNA in Zhongnan Hospital of Wuhan University,from January 2017 to April 2021.In the same period,248 patients younger than70 years old served as controls.The diagnostic value and safety of EBUS⁃TBNA in the diagnosis of elderly patients were evaluated.Results:In the elderly group,the average age was(75.2±4.0)years,and males accounted for 76.9%.The comorbidities of hypertension,coronary heart disease,COPD,and diabetes were 17.3%,13.4%,30.8%,and 9.6%,respectively.The proportion of COPD was significantly higher than that of patients under 70 years old(16/36 vs 31/248,P<0.01).EBUS⁃TBNA had a sensitivity of 95.3%and a specificity of 100%in the diagnosis of mediastinal and hilar diseases of the elderly.In terms of safety,2 cases of puncture point bleeding,2 cases of transient hypotension,4 cases of transient arrhythmia,10 cases of transient hypoxemia,and 4 cases of elevated carbon dioxide were found in the elderly group,and no difference in the complications between the two groups was found.Conclusion:EBUS⁃TBNA has good diagnostic value and safety in elderly patients with mediastinal and hilar diseases.

关 键 词：超声支气管镜 针吸活检 肺门病变 纵隔病变 老年 安全性 

分 类 号：R734.6[医药卫生—肿瘤]