新型支气管镜活检方式在肺癌诊断中的应用价值  

The application value of a new bronchoscopy biopsy method in the diagnosis of lung cancer

作　　者：肖珂瑶 刘卫庭 石芷男 陈聪 XIAO Keyao;LIU Weiting;SHI Zhinan;CHEN Cong(Department of Respiratory and Critical Care Medicine,The Shaoyang Affiliated Hospital,Hengyang Medical School,University of South China,Hengyang 421001,China)

机构地区：[1]南华大学衡阳医学院附属邵阳医院呼吸与危重症医学科,湖南衡阳421001

出　　处：《湖南文理学院学报(自然科学版)》2025年第1期72-78,共7页Journal of Hunan University of Arts and Science(Science and Technology)

基　　金：湖南省科技创新计划(2020SK52002)。

摘　　要：为了研究新型活检方法在肺癌诊断中的应用价值,选取影像学提示周围性肺癌且位于上叶前段、上叶后段和下叶基底段的直径约2~5 cm的患者各60例,按随机数字表法将各段患者分为2组,每组30例,分别用新型活检法(测距法)及普通活检法行支气管镜下肺活检(TBLB);选取考虑中央型肺癌黏膜浸润型的患者120例,按随机数字表法将各段患者分为2组,每组60例,随机分组后分别用新型活检方法(固定旋转法)及普通活检方法行黏膜活检,并记录前4次活检所花费时长;所有患者均以细胞学、组织学病理诊断作为金标准,观察2种方法在肺恶性肿瘤诊断中的应用价值。实验结果表明:(1)各段中普通活检方法组与新型活检方法组患者的性别、年龄差异无统计学意义(P>0.05)。(2)普通活检方法组与新型活检方法组患者对上叶前段、下叶背段、后基底段病灶的诊断阳性率分别为30.0%vs 56.6%、26.6%vs 53.3%、33.3%vs 50.0%,上述三段2种方法的阳性率差异有统计学意义(P<0.05);普通活检方法组与新型活检方法组对中央型肺癌黏膜浸润型患者的诊断阳性率分别为65.0%和70.0%,2种方法诊断阳性率差异无统计学意义(P>0.05);普通活检方法与新型活检方法组患者对患者活检的时长分别为(79.71±9.29)s、(48.67±6.72)s,2种方法对中央型占位的活检时长差异有统计学意义(P<0.05)。(3)普通活检法与新型活检法的中央型及周围型占位患者均未出现气胸,但半数患者会出现少量咯血,且2组患者中咯血量大于100 mL的发生率差异无统计学意义(P>0.05)。新型活检方法可提高部分周围型肺癌的诊断阳性率,缩短中央型肺癌黏膜活检时长。To study the application value of a new bronchoscopy biopsy method in the diagnosis of lung cancer,60 patients with peripheral lung cancer with the diameter of 2~5 cm in the anterior segment of upper lobe were selected and randomly divided into two groups of 30 patients each according to a random number table method.Then the patients underwent TBLB using the new bronchoscopy biopsy method(range-finding method)and the conventional biopsy method,respectively.A total of 120 patients with central type space occupying lesions or bronchoscopic mucosal lesions were selected and randomly divided into two groups of 60 patients each according to a random number table method.After randomization,the patients were subjected to mucosal biopsy using a novel bronchoscopic biopsy method(fixed rotation method)and a conventional biopsy method,respectively,and the time spent on the first four biopsies was recorded.Cytological and histological pathology were used as the gold standard in all patients,and the application value of these two techniques in the diagnosis of lung malignant tumors was observed.The experimental results indicate that:(1)There was no significant difference in gender and age between the conventional biopsy method group and the new biopsy method group(P>0.05).(2)The diagnostic positive rates of the anterior segment of upper lobe,dorsal segment of lower lobe and posterior basal segment were 30.0%vs 56.6%,26.6%vs 53.3%;33.3%vs 50.0%in the conventional biopsy method group and the new biopsy method group,respectively.The positive rate of the above three sections by the two methods had statistical significance(P<0.05).The diagnostic positive rates of the conventional biopsy method group and the new biopsy method group for patients with central-type space-occupying lesions were 65.0%and 70.0%,respectively,with no statistically significant difference in diagnostic positive rates between the two methods(P=0.066>0.05).The duration of biopsy for patients with central lesions in the conventional biopsy method group and the

关 键 词：支气管镜 活检 出血 安全性 

分 类 号：R563[医药卫生—呼吸系统]