论文部分内容阅读
目的探讨气管针吸活检术(Guided transbronchial needle aspiration,TBNA)在纵隔肺门肿大淋巴结诊断中的作用。方法回顾性分析2013年5月到2015年5月在我院经胸部CT检查发现纵隔肺门淋巴结肿大≥1cm的患者68例,均行气管针吸活检术检查,分析患者行TBNA检查的阳性率,分析TBNA检查诊断肺癌的灵敏度、特异度、准确性等效能指标,总结TBNA检查的不良反应发生情况。结果 68例患者经TBNA检查,阳性59例,其中鳞癌16例,腺癌17例,小细胞癌26例;TBNA检查阴性9例,经纵隔镜、胸腔镜或开胸手术后组织病理学确诊腺癌1例,小细胞癌2例,结核性淋巴结炎4例,炎性增生2例;TBNA检查诊断肺癌的灵敏度为95.16%、特异度100%、阳性预测值100%、阴性预测值66.67%,准确率95.59%;68例患者行TBNA检查,18例发生不良发应,不良反应发生率为26.47%,其中12例(17.65%)发生少量咳血;1例(1.47%)术中明显出血,出血量超过100mL;5例(7.35%)检查中发生呛咳;所有患者无死亡、无气胸、无纵隔气肿等严重不良反应发生。结论气管针吸活检术检查纵隔肺门淋巴结肿大患者的诊断准确率高,安全性好。
Objective To investigate the role of Guided transbronchial needle aspiration (TBNA) in the diagnosis of enlarged mediastinal hilar lymph nodes. Methods Retrospective analysis from May 2013 to May 2015 in our hospital by chest CT examination of mediastinal hilar lymph nodes were found in ≥ 1cm in 68 patients were tracheal needle aspiration biopsy, analysis of patients with positive TBNA examination Rate, analysis TBNA diagnostic sensitivity, specificity, accuracy and other performance indicators to summarize the adverse reactions TBNA check the situation. Results Sixty-eight patients were confirmed by TBNA, including 59 cases of squamous cell carcinoma, 17 cases of adenocarcinoma and 26 cases of small cell carcinoma. Nine patients were negative by TBNA test and were confirmed by histopathology after mediastinoscopy, thoracoscope or thoracotomy 1 case of adenocarcinoma, 2 cases of small cell carcinoma, 4 cases of tuberculous lymphadenitis and 2 cases of inflammatory hyperplasia. The sensitivity of TBNA in diagnosing lung cancer was 95.16%, the specificity was 100%, the positive predictive value was 100%, the negative predictive value was 66.67% , And the accuracy rate was 95.59%. 68 patients underwent TBNA examination and 18 patients had adverse reactions. The incidence of adverse reactions was 26.47%, of which 12 (17.65%) had a small amount of hemoptysis. One patient (1.47% , Bleeding more than 100mL; 5 cases (7.35%) check cough occurred; all patients without death, no pneumothorax, no serious mediastinal emphysema and other serious adverse reactions. Conclusion Tracheal needle aspiration biopsy in patients with mediastinal hilar lymphadenopathy diagnosis of high accuracy, good safety.