引导鞘管在径向超声引导肺外周病灶诊断中的价值

发布时间：2018-07-13 08:36

【摘要】：目的评价引导鞘管(guide sheath,GS)在非X线下支气管内径向超声引导经支气管肺活检(EBUS-TBLB)中对肺外周病灶的诊断价值。方法回顾性分析2012年7月至2015年6月在北京大学第一医院行胸部CT检查发现肺外周病灶,并在支气管内径向超声引导下行经支气管肺活检的患者。根据活检操作,将患者分为GS组、非GS组、双活检组,对比分析三组的诊断率情况。结果入选118例患者,共126个肺外周病灶,总诊断率为60.3%(76/126)。GS组、非GS组、双活检组诊断率分别为65.4%(36/55)、61.5%(8/13)、59.6%(31/52),差异均无统计学意义(χ~2=0.394,P=0.821)。GS组、非GS组、双活检组在病灶≤20 mm诊断率分别为66.7%(18/27)、0.0%(0/3)、78.6%(11/14),非GS组诊断率明显低于其他二组,差异有统计学意义(χ~2=6.8,P=0.033);病灶20 mm诊断率分别为64.3%(18/28)、80.0%(8/10)、54.1%(20/37),三组间差异无统计学意义(χ~2=2.301,P=0.301)。结论 EBUS-TBLB中使用GS在≤20 mm的肺外周病灶中能明显提高诊断率,20 mm的病灶中不能提高诊断率,GS活检后更换普通活检钳重复活检不能进一步提高诊断率。
[Abstract]:Objective to evaluate the diagnostic value of guided sheath tube (guide sheath-GS) in non-X ray guided transbronchial lung biopsy (EBUS-TBLB). Methods from July 2012 to June 2015, patients with peripheral lung lesions were examined by chest CT in the first Hospital of Peking University and underwent transbronchial lung biopsy under the guidance of bronchus diameter ultrasound. According to the biopsy procedure, the patients were divided into three groups: GS group, non GS group and double biopsy group. Results there were 126 peripheral pulmonary lesions in 118 patients, the total diagnostic rate was 60.3% (76 / 126). GS group, non-GS group and double biopsy group were 65.4% (36 / 55) or 61.5% (8 / 13) or 59.6% (31 / 52) respectively. There was no significant difference between the two groups. In the double biopsy group, the diagnostic rate of the lesions 鈮，

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