Ogirala R G, Agarwal V, Vizioli L D, Pinsker K L, Aldrich T K
Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY 10467-2490.
Am Rev Respir Dis. 1993 May;147(5):1291-4. doi: 10.1164/ajrccm/147.5.1291.
In 31 patients with exudative pleural effusions, we compared the diagnostic yield of the Abrams pleural biopsy needle with that of a new instrument, the Raja pleural biopsy needle. Each patient was randomly biopsied with both needles, and a total of 153 pleural biopsies were done, 73 with the Abrams needle and 80 with the Raja needle. No complications resulted from biopsies with either needle. Etiologic diagnoses were possible in 38 (52%) biopsies obtained using the Abrams needle, compared with 66 (82.5%) for those using the Raja needle; the difference in proportions for the diagnostic yield was statistically significant (p < 0.01, two-tailed Fisher's exact test). There were no significant differences between the needles in obtaining etiologic diagnoses in any specific disease category. The difference between the mean size of the pleural specimens obtained with the two needles was also statistically significant (p < 0.001, Mann-Whitney U test). The Raja pleural biopsy needle is easy and safe to use, and despite its smaller external diameter yields a significantly larger pleural tissue sample and significantly increases the diagnostic yield of pleural biopsies compared with the Abrams pleural biopsy needle.
在31例渗出性胸腔积液患者中，我们比较了Abrams胸膜活检针与一种新型器械——Raja胸膜活检针的诊断成功率。对每位患者均用这两种针进行随机活检，共进行了153次胸膜活检，其中使用Abrams针73次，使用Raja针80次。两种针活检均未导致并发症。使用Abrams针获得的活检标本中有38例（52%）可作出病因诊断，而使用Raja针的为66例（82.5%）；诊断成功率的比例差异具有统计学意义（p<0.01，双侧Fisher精确检验）。在任何特定疾病类别中，两种针在获得病因诊断方面均无显著差异。两种针所获胸膜标本的平均大小差异也具有统计学意义（p<0.001，Mann-Whitney U检验）。Raja胸膜活检针使用简便且安全，尽管其外径较小，但与Abrams胸膜活检针相比，能获取显著更大的胸膜组织样本，显著提高胸膜活检的诊断成功率。
