经支气管镜针吸活检术在纵膈占位病变中的临床应用价值

目的 探讨当前支气管镜针吸活检术（transbronchial needle aspiration，TBNA） 在纵膈占位病变诊断价值。方法 回顾性分析总结 2013 年 7 月至 2014 年 10 月河北大学附属医院 68 例患者经 CT 扫描发现纵膈占位，接受支气管镜针吸活检术检查后的临床资料。结果 所研究的患者，在常规支气管镜下有 22 例获得诊断，其中恶性病变 16 例，良性病变 6 例，确诊率 32.35％(22/68)；经 TBNA 检查后 57 例获得诊断，其中恶性病变 42 例，良性病变 15 例，确诊率 83.82％(57/68)。TBNA在纵膈占位病变良恶性诊断和鉴别诊断方面的敏感性、特异性和准确性分别为95.45％(42/44)，62.5%(15/24) 和83.82%(57/68)。所有患者检查耐受良好，有 2 例出现了少量出血，给予对症止血治疗。结论 在新技术快速发展的今天，对于纵膈占位病变，TBNA 目前仍然是一种安全、有效的诊断及鉴别诊断方法。

Clinical value of transbronehial needle aspiration in the diagnosis of mediastinal occupied lesions

Objective Objective To evaluate the value of transbronehial needle aspiration(TBNA)in the diagnosis of mediastinal occupied lesions. Methods A retrospective study was conducted in 68 consecutive patients with mediastinal occupied lesions. The patients underwent TBNA by using a flexible bronchoscope from July 2013 to October 2014. Results In all patients, the diagnostic rate was 32.35% by routine bronchoscopy(22/68), and TBNA achieved definitive diagnoses in 57 patients (83.82%). The sensitivity, specificity, accuracy of TBNA in distinguishing malignant mediastinal lesions were 95.45%(42/44), 62.5%(15/24) and 83.82%(57/68) respectively. EBUS was well tolerated by all of the patients, and 2 patients showed bleeding a little at the puncture site, who did not need special treatment. Conclusion With the rapid developments of new technology, the TBNA of mediastinal occupied lesions is still a minimally invasive and safe diagnostic technique.