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线性支气管内超声引导下活检的并发症:叙述性综述

Complications of linear endobronchial ultrasound guided biopsies: narrative review.

作者信息

Rizvi Bisharah, Pineda Jorge A Munoz, Nostrand Keriann Van, Miller Russell, Cheng George, Patel Niral M

机构信息

Department of Pulmonary and Critical Care Medicine, United Health Services Southern California Medical Education Consortium, Temecula, CA, USA.

Interventional Pulmonology, Division of Pulmonary, Critical Care, Sleep Medicine & Physiology, University of California San Diego, San Diego, CA, USA.

出版信息

Mediastinum. 2025 May 21;9:12. doi: 10.21037/med-24-33. eCollection 2025.

Abstract

BACKGROUND AND OBJECTIVE

Linear endobronchial ultrasound (EBUS) has become a key tool for diagnosing pulmonary diseases, offering high diagnostic yield for both malignant and non-malignant conditions. With its increased use, more complications are being reported. The objective of this narrative review is to discuss the complications associated with linear EBUS.

METHODS

A literature search using PubMed and Google Scholar from 2009 to 2024 was done. We included case reports, prospective, and retrospective studies reporting linear EBUS complications.

KEY CONTENT AND FINDINGS

Overall complications from EBUS range from 0.04% to 17%. Most common are infectious complications which are 0.04-4%. These include mediastinitis, pneumonia, pericarditis, bacteremia, tumor bed infection, lung abscess, empyema, and septic shock. Other complications include pneumothorax, pneumomediastinum, pneumopericardium, pneumoperitoneum, and subcutaneous emphysema. Complications due to anesthesia or equipment malfunction can occur as well. Hemorrhagic complications have been reported as well. Mortality is low 0.01-0.04%, and four cases have been reported that led to death from complications.

CONCLUSIONS

With increased use of EBUS as a diagnostic tool, number of complications will increase. Clinicians performing the procedures should be aware of types of possible complications that can occur and follow the patients closely after the procedure. Rapid diagnosis and treatment should be done to avoid fatal outcomes.

摘要

背景与目的

线性支气管内超声(EBUS)已成为诊断肺部疾病的关键工具,对恶性和非恶性疾病均具有较高的诊断率。随着其使用的增加,报告的并发症也越来越多。本叙述性综述的目的是讨论与线性EBUS相关的并发症。

方法

使用PubMed和谷歌学术搜索2009年至2024年的文献。我们纳入了报告线性EBUS并发症的病例报告、前瞻性和回顾性研究。

关键内容与发现

EBUS的总体并发症发生率为0.04%至17%。最常见的是感染性并发症,发生率为0.04%至4%。这些包括纵隔炎、肺炎、心包炎、菌血症、肿瘤床感染、肺脓肿、脓胸和感染性休克。其他并发症包括气胸、纵隔气肿、心包积气、气腹和皮下气肿。也可能发生麻醉或设备故障引起的并发症。也有出血性并发症的报告。死亡率较低,为0.01%至0.04%,有4例报告因并发症导致死亡。

结论

随着EBUS作为诊断工具使用的增加,并发症的数量将会增加。实施该操作的临床医生应了解可能发生的并发症类型,并在操作后密切随访患者。应迅速进行诊断和治疗,以避免致命后果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c017/12260959/ec5711651309/med-09-12-f1.jpg

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