30例经支气管镜针吸活检术在老年患者中的临床应用

Clinical Observation of Bronchoscopic Aspiration Biopsy Used in the Elderly Patients

目的：研究探讨经支气管镜针吸活检术在老年患者中的临床应用。方法：对30例经胸部CT检查提示有肺部占位性病变存在，并伴有纵隔、肺门及支气管周围淋巴结肿大的患者行经支气管镜针吸活检术，并对经支气管镜针吸活检术的诊断准确率、穿刺成功率、阳性率等进行计算和观察。结果：患者的穿刺位置在1个到3个之间，30例老年患者共穿刺43次，穿刺成功34次，穿刺的成功率为79．1％。28例患者能明确诊断，诊断的准确率为93．3％，共诊断出肺癌13例（包括腺癌9例，鳞癌和小细胞癌各2例），良性病变15例（包括结核、肺炎各5例，结节病4例，纵隔淋巴结增生性炎症1例）；其中13例肺癌患者，共穿刺18次，穿刺成功15次，穿刺成功率为83．3％，穿刺阳性13次，穿刺阳性率为72．2％；15例良性病变患者，共穿刺20次，穿刺成功17次，穿刺成功率为85．0％，穿刺阳性16例，穿刺阳性率为80．O％；2例患者诊断不明，穿刺5例，成功2次，穿刺成功率40．0％，穿刺阳性0，阳性率0。结论：经支气管镜针吸活检术在诊断老年患者的纵隔、肺门及支气管周围淋巴结病变等的过程中具有准确率高、安全性好的特点，具有十分重要的临床应用价值；同时，其在诊断的过程中还具有操作简便、创伤小、经济性好、术后的并发症发生率低等优点，值得在肺部疾病的临床诊断过程中推广。

OBJECTIVE ： To explore clinical observation of bronchoscopic aspiration biopsy used in the elderly patients. METHODS ： 30 Patients were examed by CT and the results showed that they had space occupying lesion in their lungs and lymphadenectasis around the mediastinum, hilus of lung and bronchus. So bronchoscopic aspiration biopsy was used in these patients. And its accurate rate, succesful rate of puncture and positive rate were measured and observed. RESULTS ： The number of times of the puncture in the 30 patients was 43 succesful puncture was 34 and succesful rate of puncture was 79. 1%. 28 Patients were diagnosed clearly and accurate rate was 93.3%. Among them 13 patients had lung cancers and 15 patients had benign pathologic changes. Among 13 patients with the lung cancer the number of times of the puncture was 18, the success was 15 and succesful rate was 83.3%. The numer of times of the positive was 13 and positive rate was 72. 2%. Among 15 patients with benign pathologic change the succesful rate of the pucture was 85.0% and positive rate of the puncture was 80. 8%. CONCLUSION： Bronchoscopic aspiration biopsy had high accuracy and safe in diagnosing the pathologic changes around the mediastinum, hilus of lung and bronchus.