肺周围型病灶应用EBUS-TBLB、CT引导肺活检的对比研究

发布时间：2018-04-21 18:47

本文选题：肺周围型病变 + CT引导经皮肺穿刺　；参考：《中国现代医学杂志》2017年12期

【摘要】：目的探究常规CT引导、强化CT引导经皮肺穿刺活检,以及支气管内超声引导经支气管镜肺穿刺活检(EBUS-TBLB)在肺周围型病变的诊断价值。方法选取2012年1月-2014年1月该院452例肺周围型病灶患者的临床资料。根据肺活检方法不同,分为常规CT引导组180例、强化CT引导组132例、EBUSTBLB组140例,比较3种活检方法取材满意率、肺癌确诊率、并发症发生率、敏感性、特异性、准确性及相关影响因素。结果 EBUS-TBLB组和强化CT引导组在气胸发生率、咯血或咯血增大率方面低于常规CT引导组(P0.05),并且EBUS-TBLB组气胸发生率低于强化CT引导组(P0.05);3种穿刺活检方法敏感性、特异性、准确性均较高。影响因素分析:在常规CT引导组,病灶大小与气胸发生率及咳血或咳血增大率相关(P0.05),在常规CT和强化CT引导组,病灶和胸壁的距离与气胸发生率相关(P0.05)。结论常规CT引导、强化CT引导经皮肺穿刺及EBUS-TBLB均可作为肺周围型病变的诊断手段,其中EBUS-TBLB损伤小、安全性高。
[Abstract]:Objective to investigate the diagnostic value of conventional CT guidance, enhanced CT guided percutaneous lung biopsy and endobronchial ultrasound guided EBUS-TBLB in the diagnosis of peripulmonary lesions. Methods the clinical data of 452 patients with peripheral pulmonary lesions from January 2012 to January 2014 were selected. According to the different methods of lung biopsy, 180 cases were divided into conventional CT guided group and 132 cases under enhanced CT guidance group. The satisfaction rate of three kinds of biopsy methods, diagnosis rate of lung cancer, complication rate, sensitivity and specificity were compared. Accuracy and related influencing factors. Results the incidence rate of pneumothorax, hemoptysis or hemoptysis in EBUS-TBLB group and enhanced CT guided group were lower than those in routine CT guidance group (P 0.05), and the incidence of pneumothorax in EBUS-TBLB group was lower than that in enhanced CT guided group (P 0.05). The accuracy is high. Analysis of influencing factors: in the conventional CT guided group, the lesion size was correlated with the incidence of pneumothorax and the rate of hemoptysis or hemoptysis (P 0.05). In the conventional CT and enhanced CT guided group, the distance between the lesion and the chest wall was correlated with the incidence of pneumothorax (P 0.05). Conclusion conventional CT guidance, enhanced CT guided percutaneous lung puncture and EBUS-TBLB can be used as diagnostic methods for peripheral pulmonary lesions, in which EBUS-TBLB damage is small and safety is high.
【作者单位】：西南医科大学附属医院呼吸内科;
【分类号】：R563;R734.2

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