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经支气管肺冷冻活检对弥漫性实质性肺疾病诊断的诊断率及安全性:1.7毫米与1.9毫米探头的比较

Diagnostic yield and safety of transbronchial lung cryobiopsy for diffuse parenchymal lung diseases diagnosis: Comparison between 1.7-mm and 1.9-mm probes.

作者信息

Ravaglia C, Sultani F, Piciucchi S, Dubini A, De Grauw A J, Martinello S, Oldani S, Maitan S, Stella F, Poletti V

机构信息

Pulmonology Unit, G.B. Morgagni Hospital/University of Bologna, Forlì Italy.

Radiology Unit, G.B. Morgagni Hospital/University of Bologna, Forlì Italy.

出版信息

Pulmonology. 2025 Dec 31;31(1):2416785. doi: 10.1016/j.pulmoe.2023.04.003. Epub 2025 Jan 21.

Abstract

: transbronchial lung cryobiopsy has been recently accepted as a valid and less invasive alternative to surgical lung biopsy. The purpose of this randomized controlled study was to evaluate, for the first time, the quality and safety of biopsy specimens obtained by using the new disposable 1.7-mm cryoprobe compared with the standard re-usable 1.9 mm cryoprobe in the diagnosis of diffuse parenchymal lung diseases. : 60 consecutive patients were prospectively enrolled and randomly assigned to two different groups: 1.9 mm (group A) and 1.7 mm (group B); primary endpoints were pathological and multidisciplinary diagnostic yield, sample size and complication rate. : the pathological diagnostic yield of cryobiopsy was 100% in group A and 93.3% in group B ( = 0.718); cryobiopsy median diameter was 6.8 mm in group A and 6.7 mm in group B ( = 0,5241). Pneumothorax occurred in 9 patients in group A and 10 in group B ( = 0.951); mild-to-moderate bleeding in 7 cases and 9 cases in group A and B respectively ( = 0.559). No death or severe adverse events were observed. : there was no statistically significant difference between the two groups, regarding diagnostic yield, adverse events and sampling adequacy.

摘要

经支气管肺冷冻活检术最近已被公认为是一种有效且侵入性较小的手术肺活检替代方法。这项随机对照研究的目的是首次评估在诊断弥漫性实质性肺疾病时,使用新型一次性1.7毫米冷冻探头与标准可重复使用的1.9毫米冷冻探头获取的活检标本的质量和安全性。60例连续患者被前瞻性纳入并随机分为两组:1.9毫米组(A组)和1.7毫米组(B组);主要终点是病理和多学科诊断率、样本大小和并发症发生率。A组冷冻活检的病理诊断率为100%,B组为93.3%(P = 0.718);A组冷冻活检标本的中位直径为6.8毫米,B组为6.7毫米(P = 0.5241)。A组有9例患者发生气胸,B组有10例(P = 0.951);A组和B组分别有7例和9例出现轻度至中度出血(P = 0.559)。未观察到死亡或严重不良事件。两组在诊断率、不良事件和采样充分性方面无统计学显著差异。

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