快速现场评价联合超细支气管镜对诊断外周(1/3)肺部感染性病变的应用价值  

Value of Rapid Field Evaluation Combined with Ultrafine Bronchoscopy for the Diagnosis of Infectious Lesions in Peripheral (1/3) Lungs

作　　者：秦田田 Qin Tiantian(Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou,Henan,450007,China)

机构地区：[1]郑州大学附属郑州中心医院,河南郑州450000

出　　处：《黑龙江医学》2024年第7期808-811,共4页Heilongjiang Medical Journal

摘　　要：目的:探讨快速现场评价(ROSE)联合超细支气管镜对诊断外周(1/3)肺部感染性病变的应用价值。方法:选取2022年1—5月郑州大学附属郑州中心医院收治的100例胸部CT检测到外周(1/3)肺部病变大于15周岁的患者作为研究对象,将其随机分为观察组和对照组,每组各50例。观察组患者应用超细支气管镜行肺泡灌洗及经支气管肺活检(TBLB),并使用ROSE技术对肺泡灌洗液、肺活检的标本进行评估,若ROSE结果为阳性,则停止气管镜操作,将肺泡灌洗液、活检标本送检验科及病理科;若ROSE结果为阴性,则重新行肺泡灌洗、TBLB及ROSE判读,若连续3次ROSE结果均为阴性,则在病变部位多点TBLB后将活检标本送病理科,灌洗液送检验科;对照组患者在常规气管镜下行肺泡灌洗、经支气管肺活检后,直接将肺泡灌洗液、活检标本送检验科及病理科。比较两组患者诊断率、气管镜操作时间(观察组包括ROSE时间)、气管镜操作次数、有效致病微生物检出率、病理结果阳性率、并发症发生情况。结果:观察组患者诊断率高于对照组患者,差异有统计学意义(χ^(2)=6.453,P<0.05)。两组患者气管镜操作时间比较,差异无统计学意义(t=-0.040,P>0.05);观察组患者气管镜操作次数大于对照组患者,差异有统计学意义(t=2.225,P<0.05)。观察组患者肺泡灌洗液有效致病微生物检出率大于对照组患者,差异有统计学意义(χ^(2)=6.453,P<0.05)。观察组患者病理结果阳性率大于对照组患者,差异有统计学意义(χ^(2)=6.986,P<0.05)。两组患者均无大咯血、气胸等严重并发症发生。结论:ROSE联合超细支气管镜诊断率高、并发症发生率低,能够提高有效致病微生物检出率及病理结果阳性率,无明显增加气管镜操作时间,对外周(1/3)肺部感染性病变的诊断具有很好的安全性和有效性。Objective:To investigate the value of rapid on-site evaluation(ROSE)combined with ultrafine bronchoscopy in the diagnosis of infectious lesions in peripheral(1/3)lungs.Methods:100 patients older than 15 years of age with peripheral(1/3)lung lesions detected by chest CT admitted to the hospital from January 2022 to May 2022 were selected as the study subjects,and they were randomly divided into the observation group and the control group,with 50 cases in each group.In the observation group,alveolar lavage and transbronchial lung biopsy(TBLB)were performed by applying ultrafine bronchoscopy and the specimens of alveolar lavage fluid and lung biopsy were evaluated using the ROSE technique.If the ROSE result was positive,the bronchoscopy was stopped and the alveolar lavage and biopsy specimens were sent for testing and pathology.If the ROSE result was negative,alveolar lavage,TBLB and ROSE interpretation were repeated.If the results of three consecutive ROSEs were negative,the biopsy specimens were sent to pathology after multipoint TBLB at the lesion site,and the lavage fluid was sent to tests.In the control group,after alveolar lavage and transbronchial lung biopsy under routine bronchoscopy,alveolar lavage fluid and biopsy specimens were sent directly to tests and pathology.The diagnosis rate,tracheoscopy operation time(including ROSE time in the observation group),the number of tracheoscopy operations,the detection rate of effective pathogenic microorganisms,the positive rate of pathological results,and the incidence of complications were compared between the two groups.Results:The diagnosis rate of the observation group was significantly higher than that of the control group,and the difference was statistically significant(χ^(2)=6.453,P<0.05).There was no statistically significant difference in the comparison of tracheoscopy operation time between the two groups(t=-0.040,P>0.05).The number of tracheoscopic operations in the observation group was greater than that in the control group,and the difference was stat

关 键 词：超细支气管镜 快速现场评价 肺部感染 外周肺病变 

分 类 号：R563.1[医药卫生—呼吸系统]