两种肺活检法对于肺周围型病变诊断的比较研究

Comparative study on two detection methods of lung biopsy in the diagnosis of pulmonary peripheral lesions

目的 比较经皮肺穿刺活检（PTLB）以及支气管纤维镜肺活检联合刷检（TBLB＋BB）两种不同肺部检查法在肺部周围型病变诊断中的应用价值。方法 选取2013年11月~2015年11月在本院治疗的186例肺周围型病变患者作为研究对象,将实施TBLB＋BB活体检测的患者作为A组（162例）,实施PTLB活体检测的患者作为B组（68例）,进行两种检测方法的患者作为C组（44例）,比较三组的确诊率。结果 C组的确诊率显著高于A组和B组,差异有统计学意义（P〈0.05）。当病灶位于肺内带或肺门时,B组的确诊率显著低于A组和C组,差异有统计学意义（P〈0.05）。当病灶位于肺外带或胸壁时,A组的确诊率显著低于B组和C组,差异有统计学意义（P〈0.05）。结论 当病灶在肺门区附近（尤其病灶在支气管内膜处）时,采用TBLB＋BB活体检查法效果最佳;当病灶靠近肺周边组织时,采用PTLB活体检测法效果最好。

Objective To compare the application value of two different lung detection methods of percutaneous lung biopsy （PTLB） and transbronchial lung biopsy combined with hrush biopsy （TBLB＋BB） in the diagnosis of pulmonary peripheral lesions. Methods 186 patients with pulmonary peripheral lesions in our hospital from November 2013 to November 2015 were selected as the research group.The patients of implementation of TBLB＋BB in vivo detection were selected as group A （162 cases）,the patients of implementation of PTLB in vivo detection were selected as group B （68 eases）,the patients of implementation of the two kinds of detection methods were selected as group C （44 eases）.The confirmed diagnosis rate among three groups was compared. Results The confirmed diagnosis rate of group C was high- er than that of group A and group B,with significant difference （P〈0.05）.The confirmed diagnosis rate of group B was lower than that of group A and group C when the lesion was in the inner zone and hilus of lung,with significant differ- ence （P〈O.05）.The confirmed diagnosis rate of group A was lower than that of group B and group C when the lesion was in the outer zone of lung and chest wall,with significant difference （P〈0.05）. Conclusion TBLB＋BB should be applied when the lesion is around the hilar area,especially on the endomembrane of bronchia.FFLB is superior when the lesion is in the peripheral tissues of lung.