经支气管镜针吸活检术在纵膈占位病变中的临床应用价值

Clinical value of transbronehial needle aspiration in the diagnosis of mediastinal occupied lesions

目的探讨当前支气管镜针吸活检术(transbronchial needle aspiration,TBNA)在纵膈占位病变诊断价值。方法回顾性分析总结2013年7月至2014年10月河北大学附属医院68例患者经CT扫描发现纵膈占位,接受支气管镜针吸活检术检查后的临床资料。结果所研究的患者,在常规支气管镜下有22例获得诊断,其中恶性病变16例,良性病变6例,确诊率32.35%(22/68);经TBNA检查后57例获得诊断,其中恶性病变42例,良性病变15例,确诊率83.82%(57/68)。TBNA在纵膈占位病变良恶性诊断和鉴别诊断方面的敏感性、特异性和准确性分别为95.45%(42/44),62.5%(15/24)和83.82%(57/68)。所有患者检查耐受良好,有2例出现了少量出血,给予对症止血治疗。结论在新技术快速发展的今天,对于纵膈占位病变,TBNA目前仍然是一种安全、有效的诊断及鉴别诊断方法。

Objective To evaluate the value of transbronehial needle aspiration（TBNA）in the diagnosis of mediastinal occupied lesions. Methods A retrospective study was conducted in 68 consecutive patients with mediastinal occupied lesions. The patients underwent TBNA by using a flexible bronchoscope from July 2013 to October 2014. Results In all patients, the diagnostic rate was 32.35% by routine bronchoscopy（22/68）, and TBNA achieved definitive diagnoses in 57 patients （83.82%）. The sensitivity, specificity, accuracy of TBNA in distinguishing malignant mediastinal lesions were 95.45%（42/44）, 62.5%（15/24） and 83.82%（57/68） respectively. EBUS was well tolerated by all of the patients, and 2 patients showed bleeding a little at the puncture site, who did not need special treatment. Conclusion With the rapid developments of new technology, the TBNA of mediastinal occupied lesions is still a minimally invasive and safe diagnostic technique.