Liang Yongxue, Jiang Xia, Ma Liwen, Li Yi, Ma Han, Wang Zhongping
Second Ward of Respiratory and Critical Care Medicine, Yan'an Hospital of Kunming City, Kunming, China.
Second Ward of Respiratory and Critical Care Medicine, Yan'an Hospital of Kunming City, Kunming, China -
Minerva Surg. 2023 Feb;78(1):37-44. doi: 10.23736/S2724-5691.22.09597-1. Epub 2022 Jul 15.
The aim of this study was to investigate the diagnostic value and safety of ultrathin bronchoscope and endobronchial ultrasonography with a guide sheath (EBUS-GS) combined with rapid on-site evaluation (ROSE) system for peripheral pulmonary infectious diseases.
The clinical data of 196 patients visiting our hospital, who had peripheral pulmonary lesions (PPLs) indicated by spiral computed tomography (CT) of the chest and were finally diagnosed as infectious PPLs, were retrospectively collected. Then the patients were divided into ultrathin bronchoscope + ROSE group, EBUS-GS + ROSE group and ultrathin bronchoscope + EBUS-GS + ROSE group based on different diagnostic techniques. Moreover, the general conditions, diagnostic results and specific operation parameters of the patients were recorded, and the diagnostic rate, sensitivity and complications were compared.
In ultrathin bronchoscope + EBUS-GS + ROSE group, the time of localizing lesions and operation time were the shortest, and the grade of bronchi reached by the bronchoscope was the highest. The differences were significant between any two groups (P<0.05). Patients with bacterial pneumonia, and patients with pulmonary tuberculosis and nontuberculous mycobacterial disease, ultrathin bronchoscope + EBUS-GS + ROSE group exhibited the highest definite diagnosis rate of bronchoscope and diagnostic sensitivity of ROSE system, with significant differences from those of the other two groups (P<0.05). The incidence rates of complications were low in all groups, and there were no significant differences between any two groups (P>0.05).
Ultrathin bronchoscope and EBUS-GS combined with ROSE system can prominently decrease the time of localizing lesions and operation time, remarkably improve the diagnostic accuracy and sensitivity and result in fewer complications.
本研究旨在探讨超细支气管镜及带引导鞘的支气管内超声（EBUS-GS）联合快速现场评价（ROSE）系统对周围型肺部感染性疾病的诊断价值及安全性。
回顾性收集我院196例胸部螺旋计算机断层扫描（CT）提示有周围型肺部病变（PPL）且最终诊断为感染性PPL的患者的临床资料。然后根据不同诊断技术将患者分为超细支气管镜+ROSE组、EBUS-GS+ROSE组和超细支气管镜+EBUS-GS+ROSE组。此外，记录患者的一般情况、诊断结果及具体操作参数，并比较诊断率、敏感性及并发症情况。
在超细支气管镜+EBUS-GS+ROSE组中，病变定位时间及操作时间最短，支气管镜到达的支气管级别最高。任意两组间差异均有统计学意义（P<0.05）。对于细菌性肺炎患者，以及肺结核和非结核分枝杆菌病患者，超细支气管镜+EBUS-GS+ROSE组支气管镜确诊率及ROSE系统诊断敏感性最高，与其他两组差异有统计学意义（P<0.05）。所有组并发症发生率均较低，任意两组间差异均无统计学意义（P>0.05）。
超细支气管镜及EBUS-GS联合ROSE系统可显著缩短病变定位时间及操作时间，明显提高诊断准确性及敏感性，且并发症较少。
