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目的探讨支气管超声下经引导鞘管肺活检术(endobronchial ultrasound transbronchial lung biopsy with guidesheath,EBUS-GS-TBLB)在肺外周病变(peripheral pulmonary lesion,PPL)诊断中的价值。方法回顾性分析30例行EBUS-GS-TBLB检查PPL患者的临床资料,与组织病理检查及临床诊断结果进行对照,计算EBUS-GS-TBLB诊断符合率,并比较不同直径病灶、不同病灶与超声探头位置关系者诊断率。结果组织病理检查证实30例中恶性病变22例,良性病变8例;患者均完成EBUS-GS-TBLB检查,检查时间(20±10)min,每例患者PPL取得活检标本(4.3±0.7)个,均未发生气胸、大咯血等并发症;EBUS-GS-TBLB诊断PPL的符合率为66.7%(20/30),其中恶性病变为77.3%(17/22),良性病变为37.5%(3/8);直径>20mm病灶诊断率(83.3%)高于直径≤20mm病灶(41.7%)(P<0.05);操作中病灶完全包绕探头者诊断率(87.5%)明显高于病灶边缘临近探头者(42.9%)(P<0.05)。结论 EBUS-GS-TBLB是诊断PPL的一种安全、有效的方法,病灶直径及超声下病灶位置与探头关系可影响诊断结果。
Objective To investigate the value of endobronchial ultrasound transbronchial lung biopsy with guidesheath (EBUS-GS-TBLB) in the diagnosis of peripheral pulmonary lesion (PPL). Methods The clinical data of 30 patients with PPL who underwent EBUS-GS-TBLB examination were retrospectively analyzed. The diagnostic accuracy of EBUS-GS-TBLB was compared with that of histopathological examination and clinical diagnosis. The diameters of different diameter lesions, Probe position relationship diagnostic rate. Results Histopathological examination confirmed 22 malignant lesions and 8 benign lesions in 30 cases. The patients underwent EBUS-GS-TBLB examination at a time of (20 ± 10) min. The biopsy specimens of each patient were (4.3 ± 0.7) , No complications such as pneumothorax and hemoptysis occurred. The coincidence rate of PPL diagnosis by EBUS-GS-TBLB was 66.7% (20/30), including 77.3% (17/22) of malignant lesions and 37.5% of benign lesions / 8). The diagnosis rate of lesions with diameter> 20mm (83.3%) was higher than that of lesions ≤20mm (41.7%) (P <0.05) Probe (42.9%) (P <0.05). Conclusion EBUS-GS-TBLB is a safe and effective method for the diagnosis of PPL. The relationship between the diameter of the lesion and the location of the lesion in sonography can affect the diagnosis.