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计算机断层扫描引导下经皮穿刺针吸活检与径向探头支气管内超声引导下经支气管肺活检在外周肺部病变中的诊断价值

[Diagnostic value of computed tomography-guided percutaneous needle biopsy versus radial probe endobronchial ultrasound-guided transbronchial lung biopsy in peripheral pulmonary lesions].

作者信息

Wang Changguo, Zeng Daxiong, Lei Wei, Jiang Junhong, Zhu Yehan, Huang Jian'an

机构信息

Department of Respiratory Medicine, the First Affiliated Hospital of Soochow University, Suzhou 215006, China.

Department of Respiratory Medicine, the First Affiliated Hospital of Soochow University, Suzhou 215006, China; Email:

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 2015 Dec;38(12):897-900.

Abstract

OBJECTIVE

To evaluate the value of computed tomography-guided percutaneous needle biopsy (CT-PNB) and radial probe endobronchial ultrasound-guided transbronchial lung biopsy (EBUS-TBLB) in the diagnosis of peripheral pulmonary lesions(PPLs).

METHODS

The clinical data of 213 patients who were diagnosed as to have PPLs in the First Affiliated Hospital of Soochow University between December 1, 2012 and October 1, 2014 were studied retrospectively. The patients were divided into CT-PNB group and EBUS-TBLB group, according to biopsy methods. The diagnostic yield, complications and influencing factors of both groups were evaluated.

RESULTS

The diagnostic yield (87.2%, 102/117) and complication rate (18.8%, 22/117) of the CT-PNB group were higher than those of the EBUS-TBLB group(61.5%, 59/96 and 18.8%, 22/117, respectively), the differences being statistically significant (χ(2)=18.906, P=0.000 and χ(2)=10.542, P=0.001, respectively). Analysis of the influencing factors showed that there were statistically significant correlations between pneumothorax and the lesion diameter(χ(2)=5.785, P=0.016) and location(χ(2)=7.559, P=0.006) in the CT-PNB group. The diagnostic yield was correlated with lesion diameter(χ(2)=7.995, P=0.004) and location(χ(2)=4.608, P=0.027) in the EBUS-TBLB group. There was no complicated pneumothorax if the lesions were attached to the chest wall in the CT-PNB group.

CONCLUSIONS

The diagnostic yield of CT-PNB in PPLs was better than that of EBUS-TBLB. Although CT-PNB had a higher complication rates, most complications were mild.

摘要

目的

评估计算机断层扫描引导下经皮穿刺针吸活检术(CT-PNB)和径向探头支气管内超声引导下经支气管肺活检术(EBUS-TBLB)在诊断周围型肺部病变(PPL)中的价值。

方法

回顾性研究2012年12月1日至2014年10月1日在苏州大学附属第一医院被诊断为PPL的213例患者的临床资料。根据活检方法将患者分为CT-PNB组和EBUS-TBLB组。评估两组的诊断率、并发症及影响因素。

结果

CT-PNB组的诊断率(87.2%,102/117)和并发症发生率(18.8%,22/117)高于EBUS-TBLB组(分别为61.5%,59/96和18.8%,22/117),差异有统计学意义(χ(2)=18.906,P=0.000;χ(2)=10.542,P=0.001)。影响因素分析显示,CT-PNB组气胸与病变直径(χ(2)=5.785,P=0.016)和位置(χ(2)=7.559,P=0.006)有统计学意义的相关性。EBUS-TBLB组诊断率与病变直径(χ(2)=7.995,P=0.004)和位置(χ(2)=4.608,P=0.027)相关。CT-PNB组中病变附着于胸壁时无复杂气胸发生。

结论

CT-PNB对PPL的诊断率优于EBUS-TBLB。虽然CT-PNB并发症发生率较高,但大多数并发症较轻。

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