EBUS-TBNA联合X线透视下经支气管肺活检术在肺门及纵隔病变中的诊断意义  

Diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration combine X-ray guided tranbronchial lung biopsy in hilar and mediastinal diseases

作　　者：胥韦 刘敏 钟樟华 裴艳丽 荣磊 Xu Wei;Liu Min;Zhong Zhanghua;Pei Yanli;Rong Lei(Department of Respiratory Medicine,The University of Hongkong-Shenzhen Hospital,Shenzhen,518053,China)

机构地区：[1]香港大学深圳医院呼吸内科,深圳518053

出　　处：《中华肺部疾病杂志（电子版）》2024年第5期680-684,共5页Chinese Journal of Lung Diseases(Electronic Edition)

基　　金：广东省自然科学基金面上项目(2024A1515012336)。

摘　　要：目的分析超声引导下经支气管针吸活检术(endobronchial bronchial ultrasound-guided transbronchial needle aspiration,EBUS-TBNA)联合经支气管镜肺活检术(tranbronchial lung biopsy,TBLB)在肺门及纵隔病变中的诊断意义。方法选择2020年8月至2021年11月我院收治的89例因肺门及纵隔病变行透视下TBLB和/或超声引导下EBUS-TBNA患者。统计分析EBUS-TBNA联合TBLB检查在肺门及纵隔病变中的诊断阳性率。结果经X线透视下TBLB和/或EBUS-TBNA行肺门和纵隔病变组织活检89例中病理诊断阳性80例(89.89%),其中肺癌69例,肺结核5例,肺结节病2例,肺真菌病1例,肺脓肿1例,机化性肺炎1例,肺放线菌病1例。89例EBUS-TBNA总活检阳性55例(61.80%),64例X线透视下TBLB总活检阳性43例(67.19%)。EBUS-TBNA联合TBLB检查64例中病理阳性诊断53例(82.81%),EBUS-TBNA检查25例中病理阳性诊断16例(64.00%),EBUS-TBNA联合TBLB检查阳性率与单独EBUS-TBNA检查阳性率差异有统计学意义(P<0.05)。结论EBUS-TBNA联合X线透视下TBLB可提高肺门及纵隔病变的病理诊断阳性率,对判断肺门及纵隔病变具有临床意义。Objective To investigate the diagnostic value of endobronchial bronchial ultrasound-guided Transbronchial Needle Aspiration combine X-ray guided tranbronchial lung biopsy in hilar and mediastinal diseases.Methods Retrospectively analyzed the clinical data of 89 patients with hilar and mediastinum diseases who underwent X-ray guided tranbronchial lung biopsy(TBLB)and/or endobronchial bronchial ultrasound-guided Transbronchial Needle Aspiration(EBUS-TBNA)in Hongkong University-Shenzhen hospital from August 2020 to November 2021.The diagnostic yield of EBUS-TBNA combined with TBLB in hilar and mediastinum diseases was analyzed.Results 89 patients with hilar and mediastinal diseases were underwent transbronchial TBLB and/or EBUS-TBNA biopsy.80 patients were pathologically positive(89.89%),69 cases of lung carcinoma,5 cases of pulmonary tuberculosis,2 cases of pulmonary sarcoidosis,one case of pulmonary mycosis,one case of pulmonary abscess,one case of organizing pneumonia and one case of pulmonary actinomycosis were diagnosed.The total biopsy positive rate of EBUS-TBNA was 61.80%(55/89),and TBLB was 67.19%(43/64).64 patients who underwent EBUS-TBNA combined with TBLB,53(82.81%)had a positive pathological diagnosis.25 patients who underwent EBUS-TBNA only,16(64.0%)had a positive pathological diagnosis.The positive rate of EBUS-TBNA combined with TBLB was statistically significantly higher than that of EBUS-TBNA alone(P<0.05).Conclusion Combination of EBUS-TBNA and X-ray guided TBLB can significantly improve the pathological diagnosis yield in hilar and mediastinal diseases.

关 键 词：超声支气管镜 针吸活检术 经支气管镜肺活检术 肺门病变 纵隔病变 

分 类 号：R563[医药卫生—呼吸系统]