电视透视下经导管支气管刷检、钳检结合选择性支气管造影诊断肺癌(附98例分析)

TV Fluoroscopy Guided Transcatheter Brushing, Forceps and Selective Bronchography in the Diagnosis of Bronchopulmonary Carcinoma (An analysis of ninety-eight cases)

目的：电视透视下经导管支气管刷检、钳检结合选择性支气管造影诊断肺癌，获得其组织学分型，以提高诊断率；材料与方法：１５０例可疑肺部癌性病变，在电视透视下经导管行刷检、钳检及选择性支气管造影。本研究首次将活钳检引入支气管途径介入诊断；结果：三年来经手术病理证实与临床随访确诊的９８例肺癌中，９０例（９０８％）经刷检找到癌细胞或可疑恶性细胞，８８例（８９２％）经钳检获肺癌的组织学分型；造影显示支气管阻塞或环形狭窄９０例（９１８％）、“旁支气管显影征”３０例（３０６％）、支气管受压移位１２例（１２３％）。术后无重要并发症；结论：经导管支气管刷检、钳检与选择性造影结合，可获得肺癌的较高的正确诊断率（９７６％）。钳检的引入，使多数（８９２％）肺癌的组织病理学分型变为可能。这是一种值得继续探索的介入放射学技术。

OBJECTIVE: TV flouroscopy guided transcatheter brushing, forceps and selective bronchography dignosis bronchopulmonary carinoma,obtain histologic type, so as to raise its accurate diagnosis rate; MATERIALS AND METHODS:150 cases which had been suspected bronchopulmonary carcinoma or pulmonary malignant tumor, were performed transcatheter brushing, forceps and selective bronhography under the guide of TV flouroscopy. Forceps were induced to transbronchal interventional operation for the first time; RESULT:98 cases were confirmed bronchopulmonary carcinoma by operation, pathology and follow-up. In the group, 90 cases (90 8%) were found carcinoma or suspected malignant cells by means of brushing ,88 cases(89 2%) obtained histologic confirmation with forceps. 90 cases showed bronchial obstruction and narrowing, 30 cases showed By-pass Sign. Bronchi displacement was discovered in 12 cases. Important complications were rare; CONCLUSION:Combination of transcatheter bronchial brushing, forceps and selective bronchography has made it possible to obtain a higher diagnosis rate (97 6%). Forceps can be used to acquire histologic diagnosis. This is a interventional radiology technique worth detecting and improving.