38例经纤维支气管镜针吸活检术对纵隔及肺门肿物诊断的临床价值分析

An Analysis of the Diagnostic Value of Transbronchial Needle Aspiration (TBNA) for 38 Cases with Lesion in Mediastina and Pulmonary Hilus

[目的]探讨经纤维支气管镜针吸活检术(TBNA)对肺门、纵隔肿物的诊断价值。[方法]对38例胸部CT检查发现纵隔、肺门软组织肿块阴影,临床诊断性质待定,常规纤维支气管镜检查无支气管腔内肿块或仅有外压性改变的患者,经纤维支气管镜穿刺针吸活检术,直接涂片送检。同时抽取胸部CT表现相同的同期肿瘤仅行常规纤维支气管镜检查的38例患者设为对照组。[结果]TBNA组诊断阳性率为86.8%,主要并发症为穿刺点少量出血,未出现纵隔气肿、感染等严重不良反应;对照组诊断阳性率为28.9%(χ2=26.125,P=0.000)。[结论]TB-NA诊断阳性率高,创伤小,特异性强,安全性高,对诊断纵隔及肺门病变性质,明确肿瘤分期有很高的临床价值。

[Purpose] To evaluate the diagnostic value on transbronchial needle aspiration（TBNA） for the lesion in mediastina and pulmonary hilus. [Methods] Thirty-night patients with the mediastina lesion detected by chest CT scanning without endobronchial mass or only with the transformation of external pressure were observed by routine bronchoscopy with a to-be-confirmed diagnosis. They were drew the tissues with TBNA for smear censorship. As the Control Group, other 38 patients with same chest CT scanning results were only examined through routine bronchoscopy. [Results] The positive rate of diagnosis with TBNA （experimental group） was 86.8%. The main complication was a small amount of bleeding at the point of aspiration. No adverse reaction or injury caused by TBNA, such as infection or pneumomediastinum. The positive rate of diagnosis was 28.9% in the control group with routine bronchoscopy （χ^2=26.125,P=0.000）. [Conclusion] TBNA plays a remarkable role on the diagnosis for the lesion in mediastina and pulmonary hilus with significant positive rate of in diagnosis and less invasion.