经气管镜针吸活检诊断纵隔疾病的价值

目的 探讨经气管镜针吸活检(TBNA)对纵隔疾病的诊断价值。方法 对32例肺CT检查显示气管、支气管旁纵隔肿物的患者进行气管镜针吸活检术，穿刺部位分别为气管旁、隆突前、隆突后、隆突下、左右气管旁。结果 19例气管镜检查无气管黏膜及管腔改变，9例出现气管轻度外压型改变，4例气管局部软骨环消失；32例患者共进行穿刺78个位点针刺活检。诊断阳性例数为24例，阳性率为75％，其中10例(31％)为非小细胞肺癌，7例(22％)为肺鳞癌，4例(13％)为肺腺癌，1例(3％)为结节病，1例(3％)为纵隔积液，1例(3％)为纵隔脓肿，其他6例(19％)涂片发现正常淋巴细胞，2例(6％)发现慢性炎症细胞，除6例(19％)穿刺后小量一过性局部出血外无其他并发症。结论 TBNA是诊断气管旁纵隔疾病安全有效的方法。

Diagnostic value of transbronchial needle aspiration in evaluation of mediastinopathy

Objective To explore the significance of transbronchial needle aspiration(TBNA)in diagnosing paratracheal mediastinal lesions.Method 32 patients with mediastinal mass diagnosed by chest CT were included.Aspiration sites contain areas involving paratracheal,post-carina,anterior-carina,and right and left parabronchus.Results Of all 32 patients,there were 19 patients with no abnormal bronchoscopic findings,9 with mild extra-lumenal compression and 4 with disappearance of tracheal ring.Positive pathology was obtained in 24(75%) cases,being 12(31%) of small cell carcinoma,7(22%) of squamous cell carcinoma,4(13%) of adenocarcinoma,1(3%) of sarcoidosis,1(3%) of mediastinal effusion and 1(3%) of mediastinal empyema respectively.Conclusion TBNA is an effective and safe method for diagnosing mediastinal diseases.