径向超声联合快速现场评估在肺外周病变的诊断价值  

Diagnostic value of endobronchial ultrasound guide sheath transbronchial lung biopsy combined with rapid on-site evaluation for peripheral pulmonary lesions

作　　者：徐春华 钟健[3] 王伟 王羽超 李丽[1,2] 袁琪 张倩[1,2] 池传珍 XU Chunhua;ZHONG Jian;WANG Wei;WANG Yuchao;LI Li;YUAN Qi;ZHANG Qian;CHI Chuanzhen(Department of Respiratory Medicine,the Affiliated Brain Hospital of Nanjing Medical University,Nanjing,Jiangsu 210029,P.R.China;Department of Respiratory Medicine,Nanjing Chest Hospital,Nanjing,Jiangsu 210029,P.R.China;Department of Thoracic Surgery,the Affiliated Brain Hospital of Nanjing Medical University,Nanjing,Jiangsu 210029,P.R.China)

机构地区：[1]南京医科大学附属脑科医院呼吸科,江苏南京210029 [2]南京市胸科医院呼吸科,江苏南京210029 [3]南京医科大学附属脑科医院胸外科,江苏南京210029

出　　处：《中国呼吸与危重监护杂志》2022年第7期493-497,共5页Chinese Journal of Respiratory and Critical Care Medicine

基　　金：江苏省卫生和计划生育委员会医学科研项目(H2017048);南京市医学科技发展重点项目(ZKX18047)。

摘　　要：目的评价径向超声经引导鞘管支气管镜肺活检术(radial probe endobronchial ultrasound guide sheath transbronchial lung biopsy,RP-EBUS-GS-TBLB)联合快速现场评估(rapid on-site evaluation,ROSE)在肺外周病变(peripheral pulmonary lesions,PPLs)诊断中的价值。方法对2018年2月—2020年8月于南京市胸科医院就诊发现的158例PPLs患者行RP-EBUS-GS-TBLB检查,随机将患者分为RP-EBUS-GS-TBLB联合ROSE组(ROSE组,n=84)和不联合ROSE组(No-ROSE组,n=84),观察两组的诊断率、操作时间、活检次数和并发症的差异。结果ROSE组诊断率为85.7%(72/84),No-ROSE组诊断率为70.3%(52/74),两组诊断敏感性差异有统计学意义(P<0.05)。ROSE组平均操作时间和活检次数均少于No-ROSE组,两组差异有统计学意义(P<0.01)。两组患者均无严重气胸、咯血等并发症。结论将ROSE技术与RP-EBUS-GS-TBLB联合应用于诊断PPLs高效安全。Objective To evaluate the diagnosis value of radial probe endobronchial ultrasound guide sheath transbronchial lung biopsy(RP-EBUS-GS-TBLB)combination with rapid on-site evaluation(ROSE)in peripheral pulmonary lesions(PPLs).Methods One hundred and fifty-eight patients with PPLs identified by computed tomography in Nanjing Chest Hospital underwent RP-EBUS-GS-TBLB with or without ROSE randomly between February 2016 and August 2017.The sensitivity,the procedure time,the biopsy times,and the complications were evaluated in the two groups.Results The diagnostic yield was 85.7%(72/84)in ROSE group and 70.3%(52/74)in No-ROSE group.There was significant difference in diagnostic sensitivity between the two groups(P<0.05).The mean procedure time and number of biopsy in ROSE group were less than those in No-ROSE group(P<0.01).No severe procedure related complications such as pneumothorax and hemoptysis were observed.Conclusions ROSE can improve the diagnostic sensitivity,and shorten the procedure time.RP-EBUS-GS-TBLB combined with ROSE is a safe and effective technique for PPLs.

关 键 词：径向超声 经支气管肺活检 快速现场评价 肺外周病变 

分 类 号：R445.1[医药卫生—影像医学与核医学] R563[医药卫生—诊断学]