超细支气管镜、GS 外周超声小探头联合快速现场评价对外周肺感染性病灶的诊断价值及安全性

目的 探讨超细支气管镜、Guide sheath外周超声小探头K201/K203系统(EBUS-GS)联合快速现场评价(玫瑰系统，rapid on site evaluation, ROSE)对外周肺感染性病灶的诊断价值和安全性。方法 回顾性收集胸部螺旋CT显示为外周肺病变且最终确诊为外周感染性肺病变的196例患者的临床资料。根据诊断技术的不同分为超细支气管镜联合ROSE组、EBUS-GS联合ROSE组、超细支气管镜和EBUS-GS联合ROSE组。记录患者的一般情况、确诊结果、具体操作参数，比较各组诊断率、敏感度以及并发症情况。结果 超细支气管镜和EBUS-GS联合ROSE组定位病变时间和操作时间最短、支气管镜到达支气管级数最高，超细支气管镜联合ROSE组定位病变时间和操作时间最长，EBUS-GS联合ROSE组支气管镜到达支气管级数最低，任意两组间差异均有统计学意义(P<0.05)。所有患者、细菌性肺炎患者、肺结核及非结核分枝杆菌病患者中，超细支气管镜和EBUS-GS联合ROSE组经支气管镜明确诊断率、ROSE诊断敏感度最高，跟另外两组相比差异有统计学意义(P<0.05)。...

The diagnostic value and safety of ultrathin bronchoscope,GS peripheral ultrasound probe combined with rapid on-site evaluation forperipheral lung infectious lesions

Objective Evaluate the diagnostic value and safety of ultrafine bronchoscope, guide sheath peripheral ultrasound probe K201/K203 system (EBUS-GS) combined with rapid on-site evaluation (ROSE) for peripheral lung infectious lesions. Methods Clinical data of 196 patients who with peripheral pulmonary lesions by chest spiral CT and finally diagnosed as peripheral infectious pulmonary lesions were retrospectively collected. According to different diagnostic techniques, the patients were divided into the ultrafine bronchoscope combined ROSE group, the EBUS-GS combined ROSE group, the ultrafine bronchoscope and the EBUS-GS combined ROSE group. The general condition, diagnosis results and specific operation parameters were recorded, and the diagnostic rate, sensitivity and complications were compared. Results The positioning time and operation time of the ultrafine bronchoscope and EBUS-GS combined ROSE group were the shortest, and the bronchoscopy reached the distal-most bronchi.The positioning time and operation time of the ultrafine bronchoscope combined ROSE group were the longest.And the bronchoscopy reached the proximal-most bronchi in the EBUS-GS combined ROSE group.All the differences were with statistically significant (P<0.05).Among all patients, for bacterial pneumonia, pulmonary tuberculosis and non-tuberculous mycobacterial disease, the bronchoscopy definitive diagnosis rate and ROSE diagnostic sensitivity were significantly the highest in the ultrafine bronchoscope group and the EBUS-GS combined with ROSE group (P<0.05).The incidence of complications in each group was low, and the difference between any two groups was not statistically significant (P>0.05). Conclusion The combination of ultrafine bronchoscope and EBUS-GS with ROSE can significantly shorten the time of localization and operation, improve the diagnostic accuracy and sensitivity, reduce complications, be safe and feasible, and report quickly and directly, which is worthy of clinical application.