近10年398例拟诊肺间质疾病患者外科肺活检结果分析

Retrospective Analysis of Surgical Lung Biopsies in 398 Cases with Interstitial Lung Disease in the Last 10 Years

目的探讨外科肺活检(SLB)诊断肺间质疾病(ILD)的价值和安全性。方法使用PubM ed、中国生物医学文献数据库、万方数据资源系统、维普数据库和CHKD期刊全文数据库,检索2000年1月至2009年12月期间我国文献报道以及南京大学医学院附属鼓楼医院2000年1月至2009年12月间接受SLB诊断ILD的病例并进行回顾性分析。结果共计398例患者接受SLB,其中221例接受开胸肺活检(OLB),177例接受电视辅助胸腔镜肺活检(VATLB)。SLB术后12例未能明确诊断,386例获得病理诊断。164例诊断为特发性间质性肺炎的病例中,38例未能明确具体病理分型,总体确诊率为87.4%。术后并发症总体发生率12.1%,死亡率2.0%。接受OLB或VATLB者在诊断率和并发症发生率上无统计学显著差异。结论 SLB是一种准确和较安全的诊断ILD的重要手段。

Objective To evaluate the diagnostic value and safety of surgical lung biopsies(SLB) in patients with interstitial lung disease(ILD).Methods A retrospective analysis was performed on patients undergoing SLB,who were obtained from Chinese literatures through searching PubMed,CBM,Wanfang database,VIP information and CHKD from 2000 to 2010.The data from Affiliated Drum Tower Hospital,Nanjing University Medical College from 2000 to 2010 was also reviewed.Results A total of 398 cases underwent SLB,including open lung biopsy(OLB) in 221 cases and video-assisted thoracoscopic lung biopsy(VATLB) in 177 cases.SLB yielded a specific diagnosis for 386 cases.The total postoperative complication rate was 12.1% and mortality rate was 2.0%.The diagnostic yield,post-operative complication rate,and mortality rate between VATLB and OLB had no significant difference.Conclusion SLB is a useful and relatively safe procedure for diagnosis of ILD.