杯状钳与鳄齿钳对经支气管肺活检结果的影响。

The effect of cup versus alligator forceps on the results of transbronchial lung biopsy.

作者信息

Jabbardarjani Hamidreza, Eslaminejad Alireza, Mohammadtaheri Zohreh, Kiani Arda, Arab Azadeh, Masjedi Mohammad Reza

机构信息

*Tracheal Disease Research Center †Chronic Lung Disease Research Center ‡Virology Research Center, Tracheal Disease Research Center §Air Pollution and Occupational Respiratory Disease Research Center ∥Clinical Tuberculosis and Epidemiology Research Center, NRITLD, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

J Bronchology Interv Pulmonol. 2010 Apr;17(2):117-21. doi: 10.1097/LBR.0b013e3181dc9920.

DOI:10.1097/LBR.0b013e3181dc9920

PMID:23168725

Abstract

BACKGROUND

Transbronchial lung biopsy (TBLB) is a routine diagnostic procedure for pulmonary diseases and is performed by using either the alligator or cup forceps. The purpose of this study was to compare the role of the type of forceps in the quality and complications of TBLB.

METHODS

This was a prospective, observational, double-blinded study. Four samples were taken from each patient through TBLB. Characteristics of the samples, including sample size and number of alveoli, whether it was diagnostic or not, and side effects such as pneumothorax and bleeding, were all recorded.

RESULTS

One hundred seventy-six biopsy samples obtained from 44 patients were evaluated; 21 patients (47.7%) were male. Of the 88 samples taken with an alligator forceps, based on size, 21.6% were small, 45.5% were medium, and 33% were large. Corresponding results for the samples taken with a cup forceps were 43.2% small, 29.5% medium, and 27.3% large. Of the 88 biopsy samples taken with an alligator forceps, 18.2% were diagnostic; this rate was 23.9% for cup forceps. Significant pneumothorax was not seen in any of the cases in the alligator forceps group, but it was detected in 9% of the cases in the cup forceps group. Significant bleeding was seen in 1% of the alligator forceps and 5.7% of the cup forceps procedures.

CONCLUSIONS

Our study results, comparing the effect of 2 different kinds of forceps on TBLB results, were consistent with those of other studies with larger samples (P=0.008) using alligator forceps. The diagnostic value of the procedures was not significantly different (P=0.355).

摘要

背景

经支气管肺活检（TBLB）是肺部疾病的常规诊断方法，可使用鳄齿钳或杯状钳进行操作。本研究旨在比较不同类型钳子在TBLB质量及并发症方面的作用。

方法

这是一项前瞻性、观察性、双盲研究。通过TBLB从每位患者获取4份样本。记录样本的特征，包括样本大小、肺泡数量、是否具有诊断价值以及气胸和出血等副作用。

结果

对从44例患者获取的176份活检样本进行了评估；21例患者（47.7%）为男性。在使用鳄齿钳获取的88份样本中，按大小分类，21.6%为小样本，45.5%为中等样本，33%为大样本。使用杯状钳获取的样本相应结果为43.2%为小样本，29.5%为中等样本，27.3%为大样本。在使用鳄齿钳获取的88份活检样本中，18.2%具有诊断价值；杯状钳获取样本的这一比例为23.9%。鳄齿钳组所有病例均未出现严重气胸，但杯状钳组有9%的病例出现严重气胸。鳄齿钳操作中有1%出现严重出血，杯状钳操作中有5.7%出现严重出血。