国产电磁导航支气管镜检查定位系统引导经支气管镜肺活检术对肺外周病灶的诊断价值
发布时间：2018-08-08 18:30
【摘要】：目的评价国产电磁导航支气管镜(electromagnetic navigation bronchoscopy,ENB)检查定位系统引导经支气管镜肺活检术(transbronchial lung biopsy,TBLB)在肺外周病灶诊断中的价值和安全性。方法收集2014年7月至12月来复旦大学附属中山医院就诊、胸部螺旋CT显示为肺外周病变的患者64例。患者随机分入试验组和对照组,试验组ENB联合X线透视下行TBLB,对照组行X线透视下TBLB。根据外科手术切除病灶的病理检查结果或随诊24个月观察临床治疗反应及病情变化进行最后确诊。同时观察和比较两组病灶的检查时间及术中术后不良事件发生情况。结果 64例患者共70处病灶。两组病灶在患者年龄、性别、病灶大小、病灶部位方面的差异均无统计学意义。试验组肺活检组织病理结果与最终诊断符合率为88.6%,对照组为62.9%,差异有统计学意义(P=0.012)。亚组分析显示:病灶长径≤2 cm时,试验组确诊率(66.7%vs.20.0%)与对照组差异无统计学意义(P=0.266);2 cm病灶长径≤3 cm时,两组确诊率差异无统计学意义(100%vs.81.8%,P=0.485);病灶长径3 cm时,两组确诊率差异有统计学意义(94.4%vs.63.1%,P=0.042)。试验组的平均总检查时间为(966±372)s,对照组为(1 040±470)s,差异无统计学意义(P=0.600);试验组寻找病灶所需X线透视时间为(7.0±4.8)s,对照组为(37.0±37.5)s,差异有统计学意义(P=0.008)。本研究中未发生气胸、严重出血等不良事件。结论对于肺外周病灶,与传统X线透视下TBLB相比,国产ENB检查定位系统引导TBLB减少寻找病灶所需X线透视时间、提高病灶组织活检病理诊断正确率,尤其在病灶长径3 cm时具有优势,且具有一定的安全性。
[Abstract]:Objective to evaluate the value and safety of (electromagnetic navigation bronchoscopy endoscopy (electromagnetic navigation bronchos copy Enb) in the diagnosis of peripheral pulmonary lesions. Methods from July to December, 2014, 64 patients with peripheral pulmonary lesions were selected from Zhongshan Hospital affiliated to Fudan University. The patients were randomly divided into the trial group and the control group. The ENB combined with X-ray fluoroscopy was used in the test group and the control group was treated with the X-ray fluoroscopy. The final diagnosis was made on the basis of the pathological findings of surgical resection of the lesions or 24 months follow-up observation of the clinical response and the changes of the disease. At the same time, the time of examination and the occurrence of adverse events in operation and postoperative were observed and compared between the two groups. Results there were 70 lesions in 64 patients. There was no significant difference in age, sex, size and location of lesions between the two groups. The coincidence rate between pathological results of lung biopsy and final diagnosis was 88.6 in the test group and 62.9 in the control group (P < 0.012). The results of subgroup analysis showed that when the lesion diameter 鈮，
本文编号：2172652
[Abstract]:Objective to evaluate the value and safety of (electromagnetic navigation bronchoscopy endoscopy (electromagnetic navigation bronchos copy Enb) in the diagnosis of peripheral pulmonary lesions. Methods from July to December, 2014, 64 patients with peripheral pulmonary lesions were selected from Zhongshan Hospital affiliated to Fudan University. The patients were randomly divided into the trial group and the control group. The ENB combined with X-ray fluoroscopy was used in the test group and the control group was treated with the X-ray fluoroscopy. The final diagnosis was made on the basis of the pathological findings of surgical resection of the lesions or 24 months follow-up observation of the clinical response and the changes of the disease. At the same time, the time of examination and the occurrence of adverse events in operation and postoperative were observed and compared between the two groups. Results there were 70 lesions in 64 patients. There was no significant difference in age, sex, size and location of lesions between the two groups. The coincidence rate between pathological results of lung biopsy and final diagnosis was 88.6 in the test group and 62.9 in the control group (P < 0.012). The results of subgroup analysis showed that when the lesion diameter 鈮，
本文编号：2172652
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