支气管内超声引导下冷冻活检诊断肺外周病变的效能及其影响因素研究  

Efficiency and influencing factors of endobronchial ultrasound-guided cryobiopsy in diagnosing peripheral pulmonary lesions

作　　者：钟如柱 庞郁炬 李辉武 关忠勇 ZHONG Ru-zhu;PANG Yu-ju;LI Hui-wu;GUAN Zhong-yong(Department of Respiratory and Critical Care Medicine,Lianjiang People's Hospital,Zhanjiang 524400,Guangdong,CHINA)

机构地区：[1]廉江市人民医院呼吸与危重症医学科,广东湛江524400

出　　处：《海南医学》2024年第22期3237-3240,共4页Hainan Medical Journal

基　　金：广东省湛江市科技专项(编号:2023B01086)。

摘　　要：目的 探讨支气管内超声引导下冷冻活检诊断肺外周病变的效能,并分析影响诊断准确度的相关因素。方法 回顾性分析2020年1月至2023年12月廉江市人民医院收治的95例肺外周病变患者临床资料,根据其活检方法将患者分为冷冻活检组(在支气管内超声引导下冷冻活检) 56例与传统钳夹活检组(进行传统钳夹活检)39例,以最终临床诊断为标准,评估支气管内超声引导下冷冻活检诊断肺外周病变的效能以及并发症发生情况。根据支气管内超声引导下冷冻活检结果与最终临床诊断结果对照情况将患者分为诊断准确组(n=44)和诊断失败组(n=12),比较两组患者的临床资料,采用多因素Logistic回归分析影响支气管内超声引导下冷冻活检诊断效能的相关因素。结果 以最终临床诊断为标准,冷冻活检组患者肺外周病变的诊断敏感度、准确度、阳性预测值、阳性似然比、阴性似然比均高于传统钳夹活检,差异均有统计学意义(P<0.05),而特异度、阴性预测值比较差异均无统计学意义(P>0.05);冷冻活检组患者诊断肺外周病变并发症总发生率为7.14%,略低于传统钳夹活检组的10.26%,差异无统计学意义(P>0.05);诊断准确组患者的病灶≤3 cm比率、并发症发生率分别为31.82%、2.27%,明显低于诊断失败组的75.00%、25.00%,差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,病灶大小是支气管内超声引导下冷冻活检诊断肺外周病变诊断准确度的影响因素(P<0.05)。结论 支气管内超声引导下冷冻活检诊断肺外周病变的效能相对较高,病灶大小是影响其诊断准确度的因素。Objective To explore the efficiency of endobronchial ultrasound-guided cryobiopsy in the diagnosis of peripheral pulmonary lesions,and to analyze the related factors affecting the diagnostic accuracy.Methods The clinical data of 95 patients with peripheral pulmonary lesions in Lianjiang People's Hospital were retrospectively analyzed from January 2020 to December 2023.According to the biopsy methods,the patients were divided into the cryobiopsy group(endobronchial ultrasound-guided cryobiopsy,n=56)and traditional clamp biopsy group(traditional clamp biopsy,n=39).The efficiency of endobronchial ultrasound-guided cryobiopsy on peripheral pulmonary lesions and occurrence of complications were assessed based on the final clinical diagnosis.According to the comparison between the results of endobronchial ultrasound-guided cryobiopsy and the final clinical diagnosis,the patients were classified into the accurate diagnosis group(n=44)and the failed diagnosis group(n=12),and the clinical data were compared between the two groups.Multivariate logistic regression analysis was adopted to analyze the related factors affecting the diagnostic efficiency of endobronchial ultrasound-guided cryobiopsy.Results With the final clinical diagnosis as standard,the diagnostic sensitivity,accuracy,positive predictive value,positive likelihood ratio,and negative likelihood ratio of peripheral pulmonary lesions in cryobiopsy group were higher than those in traditional clamp biopsy group(P<0.05),but there were no statistically significant differences in specificity and negative predictive value(P>0.05).The total incidence rate of complications of peripheral pulmonary lesion in the cryobiopsy group was 7.14%,which was slightly lower than 10.26%in traditional clamp biopsy group(P>0.05).The ratio of lesion≤3 cm and incidence of complications in the accurate diagnosis group were 31.82%and 2.27%,respectively,significantly lower than 75.00%and 25.00%in the failed diagnosis group(P<0.05).Multivariate logistic regression analysis indicated that l

关 键 词：肺外周病变 支气管内超声 冷冻活检 诊断 影响因素 

分 类 号：R655.3[医药卫生—外科学]