[虚拟支气管镜导航辅助经引导鞘支气管内超声对周围型肺病变的诊断价值]
[Diagnostic Utility of Virtual Bronchoscopic Navigation Assisted Endobronchial Ultrasonography with Guide Sheath for Peripheral Pulmonary Lesions].
作者信息
Li Shijie, Yan Wanpu, Chen Mailin, Sun Li, Wu Qi, Chen Keneng
机构信息
Department of Endoscopy Center, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing 100142, China.
The First Department of Thoracic Surgery, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing 100142, China.
出版信息
Zhongguo Fei Ai Za Zhi. 2019 Mar 20;22(3):125-131. doi: 10.3779/j.issn.1009-3419.2019.03.01.
BACKGROUND
Virtual bronchoscopic navigation (VBN) assisted endobronchial ultrasonography with guide sheath (EBUS-GS) has reduced the difficulty and even avoiding radiation exposure during performing transbronchus lung biopsy (TBLB). To evaluate the feasibility and safety of virtual bronchoscopic navigation assisted endobronchial ultrasonography with guide sheath for peripheral pulmonary lesions.
METHODS
We performed a retrospective analysis of the patients with PPLs who received VBN assisted EBUS-GS-TBLB in Peking University Cancer Hospital from January 2016 to December 2017. Their clinicopathologic data and complications were assessed.
RESULTS
A total of 121 patients were enrolled in the study. The patients included 65 men and 56 women, with a mean age of (58.8±10.3) years. A total of 121 PPLs were examined, and 108 lesions of which could be detected by EBUS. The overall diagnostic yield of EBUS-GS was 73.5%. The diagnostic yield of malignancy was 82.5%. The combination of transbronchial lung biopsy, brush smear and bronchoalveolar lavage fluid provided the greatest diagnostic yield (χ²=6.084, P=0.014). Factors that significantly affected and predicted diagnostic success were EBUS probe within the lesions (χ²=20.372, P=0.000) and PPLs located in the central two-thirds of the lung (χ²=10.810, P=0.001). 1 patient (0.8%) suffered from intraoperative bleeding which could be managed under endoscopy.
CONCLUSIONS
VBN assisted EBUS-GS-TBLB for PPLs was an effective and safe procedure.
背景
虚拟支气管镜导航（VBN）辅助带引导鞘的支气管内超声检查（EBUS-GS）降低了经支气管肺活检（TBLB）操作的难度，甚至避免了辐射暴露。旨在评估虚拟支气管镜导航辅助带引导鞘的支气管内超声检查用于周围型肺部病变的可行性和安全性。
方法
我们对2016年1月至2017年12月在北京大学肿瘤医院接受VBN辅助EBUS-GS-TBLB的周围型肺部病变患者进行了回顾性分析。评估了他们的临床病理数据和并发症。
结果
共纳入121例患者。患者包括65名男性和56名女性，平均年龄（58.8±10.3）岁。共检查了121个周围型肺部病变，其中108个病变可通过EBUS检测到。EBUS-GS的总体诊断率为73.5%。恶性病变的诊断率为82.5%。经支气管肺活检、刷检涂片和支气管肺泡灌洗联合应用提供了最高的诊断率（χ²=6.084，P=0.014）。显著影响并预测诊断成功的因素是病变内的EBUS探头（χ²=20.372，P=0.000）和位于肺中央三分之二区域的周围型肺部病变（χ²=10.810，P=0.001）。1例患者（0.8%）术中出血，可在内镜下处理。
结论
VBN辅助EBUS-GS-TBLB用于周围型肺部病变是一种有效且安全的方法。
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