超声支气管镜在肺门及纵隔病变诊断中的应用价值分析  

Application value of ultrasound bronchoscopy in the diagnosis of hilar and mediastinal diseases

作　　者：刘宜根 陈焕[1] 王志国[1] 昝银花[1] 徐小兵 LIU Yi-gen;CHEN Huan;WANG Zhi-guo;ZAN Yin-hua;XU Xiao-bing(Department of Respiratory and Critical Care Medicine,Naval Anqing Hospital of the Chinese People’s Liberation Army,Anqing 246003,Anhui,China)

机构地区：[1]中国人民解放军海军安庆医院呼吸与危重症医学科,安徽安庆246003

出　　处：《川北医学院学报》2023年第1期84-87,共4页Journal of North Sichuan Medical College

基　　金：安徽省安庆市医疗卫生类科技计划项目(2020Z6004)。

摘　　要：目的:分析肺门及纵隔病变中超声支气管镜的诊断价值。方法:回顾性分析50例肺门及纵膈淋巴结肿块患者的临床资料,所有患者均行超声支气管镜针吸活检术检查,记录穿刺淋巴结位置、穿刺时间,计算超声支气管镜检查对肺门及纵隔病淋巴结肿块的诊断结果及效能,比较不同直径淋巴结肿块恶性病变诊断情况。结果:50例患者共穿刺87处淋巴结肿块,其中淋巴结包括4R组19例(38.00%)患者共30处(34.48%)肿块,4L组6例(12.00%)患者共11处(12.64%)肿块,7组25例(50.00%)患者共46处(52.88%)肿块;平均操作时间为(21.06±1.34)min;病理检查结果显示,50例患者中良性病变患者11例(22.00%),恶性病变患者39例(78.00%);超声支气管镜对全部患者的诊断准确度、敏感度及特异度分别为92.00%、89.74%、100.00%,与病理结果一致的Kappa值=0.794;淋巴结肿块直径>2 cm组诊断阳性率为86.21%,高于淋巴结肿块直径≤2 cm组的51.72%(P<0.05)。结论:超声支气管镜对肺门及纵隔病变具有良好的诊断价值,且穿刺活检无严重并发症,安全性较高。Objective:To analyze the diagnostic value of ultrasound bronchoscopy in the diagnosis of hilar and mediastinal diseases.Methods:The clinical data of 50 patients with hilar and mediastinal lymph node lumps were retrospectively analysed.All underwent needle biopsy under ultrasound bronchoscopy.The sites of punctured lymph nodes and puncture time were recorded.The diagnostic results and efficiency of ultrasound bronchoscopy for hilar and mediastinal lymph node lumps were calculated.The diagnostic results of malignant lesions in lymph node lumps with different diameters were compared.Results:In the 50 patients, there were 87 lymph node lumps.There were 19(38.00%) patients(30 lymph node lumps, 34.48%) in 4R group, 6(12.00%) patients(11 lymph node lumps, 12.64%) in 4L group and 25(50.00%) patients(46 lymph node lumps, 52.88%) in 7 group.The average operation time was(21.06 ±1.34) min.The results of pathological examination showed that among the 50 patients, there were 11 cases(22.00%) with benign lesions and 39 cases(78.00%) with malignant lesions.The diagnostic accuracy, sensitivity, specificity were 92.00%,89.74% and 100.00%,Kappa value of ultrasound bronchoscopy and pathological examination was 0.794.The diagnostic positive rate in lump>2cm group was higher than that in lump≤2cm group(86.21% vs.51.72%,P<0.05).Conclusion:Ultrasound bronchoscopy has good diagnostic value for hilar and mediastinal diseases.There are no serious complications in needle biopsy, with high safety.

关 键 词：肺门淋巴结 纵膈淋巴结 超声支气管镜 

分 类 号：R445.1[医药卫生—影像医学与核医学] R734.2[医药卫生—诊断学]