经纤维支气管镜针吸活检诊断纵隔病变

目的探讨纤维支气管镜针吸活检术对肺门、纵隔不明原因肿块的诊断价值。方法选择肺部CT检查发现有纵隔、肺门软组织块状阴影,临床诊断性质待查,常规纤维支气管镜检查无支气管腔内肿块病变的患者,经过CT定位后,予以纤维支气管镜下穿刺针吸活检检查。结果44例患者,穿刺成功获得病理诊断者32例(72.7%)。其中诊断肺癌者30例,结核2例,此外,核异质细胞4例,另外8例患者为正常淋巴结和正常气道黏膜上皮细胞。部分患者施行针吸活检术后穿刺点局部微量出血,不需要止血处理;无其他并发症。结论经纤维支气管镜针吸活检是鉴别诊断纵隔、肺门不明原因肿块和肿大淋巴结的有效手段,不良反应少而轻微,有较高的临床诊断价值,值得推广应用。

The clinical utility of transbronchial needle aspiration in the diagnosis of mediastinal solid masses

Objective To explore the clinical value of transbronchial needle aspiration(TBNA) in the diagnoses of subcarinal and hilar lymph nodes and solid masses.Methods Forty-six patients with undefined subcarinal and hilar lymph nodes or solid masses were performed transbronchial needle aspiration under bronchoscopy.Results Of 44 patients,thirty-eight presented positive pathological results.Among them,thirty cases were diagnosed as lung cancer and two cases tuberculosis.Dyskaryosis cells were seen in other four cases and no abnormal changes in the remaining eight cases.No severe complications were observed during and after the operation.Conclusion Transbronchial needle aspiration is a useful and safe procedure and worthy of a wider application for the diagnosis of subcarinal and hilar lymph nodes or solid masses.