导向鞘引导超声支气管镜肺活检术在外周肺结节诊断中的临床应用

目的 探讨导向鞘引导的超声支气管镜检查技术在诊断外周肺结节中的临床应用及安全性。方法 回顾性分析2018年1月至2019年9月在空军军医大学唐都医院呼吸与危重症医学科气管镜室接受导向鞘引导超声支气管镜肺活检术(endobronchial ultrasonography with a guide sheath transbronchial lung biopsy,EBUS-GS-TBLB)检查的患者67例,研究EBUS-GS-TBLB对外周肺结节病理活检诊断阳性率及其影响因素。结果 EBUS-GS-TBLB对外周肺结节的总诊断率为70.15%,其中病灶支气管征阳性患者的诊断率为80.49%,明显高于支气管征阴性患者,差异有统计学意义(χ²=5.393,P＜0.05);病灶大小、位置、与胸膜的距离及病灶类型对EBUS-GS-TBLB病理活检诊断率的影响均无显著统计学差异。结论 与常规支气管镜检查相比,EBUS-GS-TBLB在提高活检诊断阳性率、降低活检风险方面具有明显优势,值得在临床推广应用,且EBUS-GS-TBLB活检阳性率在支气管征阳性患者中表现出显著优势,从而有利于从优选择肺外周结节病理活检方法,以达到提高肺癌早期诊断率的目的。

Clinical application of endobronchial ultrasonography with a guide sheath transbronchial lung biopsy in peripheral pulmonary nodules

Objective To evaluate the clinical application and safety of Endobronchial ultrasonography with a guide sheath transbronchial lung biopsy( EBUS-GS-TBLB) in diagnosing peripheral pulmonary Lesions.Methods A Retrospective analysis of 67 patients with peripheral Pulmonary nodules diagnosed by Endobronchial ultrasonography with a guide sheath( EBUS-GS) from January 2018 to September 2019 in Tangdu Hospital of Air Force Military Medical University,To explore the diagnostic positive rate of pathological biopsy of peripheral pulmonary nodules with EBUS-GS-TBLB and its influencing factors.Results The total diagnostic rate of EBUS-GS-TBLB?was 70.15%,the patients with CT bronchus sign positivity,diagnostic rate was 80.49%,significantly higher than those patients CT bronchus sign negativity(χ² =5.393,P=0.029);The size,location,distance from pleura and the type of Lesion types had no influence in the diagnostic rate of pathological biopsy by EBUS-GS-TBLB.Conclusion Compared with conventional tracheoscopy,EBUS-GS-TB-LB has obvious advantages in increasing the positive rate of biopsy diagnosis and reducing the risk of biopsy,and it is worth popularizing in clinic,and the positive rate of EBUS-GS-TBLB biopsy shows a significant advantage in the positive patients with bronchial sign,which is beneficial to select the pathological biopsy method of lung peripheral nodules from the superior,so as to achieve the purpose of improving the early diagnosis rate of lung cancer.