超声支气管镜引导下的经支气管针吸活检术的临床应用分析

Analysis of clinical application of endobronchial ultrasound-guided transbronchial needle aspiration

目的研究超声支气管镜引导下的经支气管针吸活检术(EBUS-TBNA)在肺恶性肿瘤及纵隔肿物中的诊断价值及安全性。方法分析我科2013年10月至2015年10月经胸部CT发现肺门、纵隔淋巴结肿大或气管支气管旁肿物的94例患者行EBUS-TBNA检查结果。结果 94例患者中确诊肺恶性肿瘤80例;共穿刺150组淋巴结,每组平均穿刺2.4针,对肺恶性肿瘤的诊断敏感性为93.02%,特异性为100%,准确性为93.62%;4例患者临床诊断结节病;4例患者临床诊断淋巴结炎。结论 EBUS-TBNA在纵隔、肺门淋巴结和气管支气管旁肿物的诊断和肺恶性肿瘤的分期上有较高的敏感性、特异性、准确性和安全性,是经济有效的诊断方法。

Objective To analyze the diagnostic value and safety of endobronchial ultrasound-guided transbronchial needle aspiration （ EBUS-TBNA） for lung cancer and mediastinal lesions.Methods 94 pa-tients with mediastinal , hilar lymph node or the mass beside main trachea or bronchus were found by chest CT under -went the diagnosis by EBUS-TBNA from October 2013 to October 2015.The sensitivity, specificity and diagnostic ac-curacy of EBUS-TBNA were evaluated .Results In the 94 patients, 80 cases were confirmed as malignant tumor by pathologically.EBUS-TBNA was successfully performed to obtain samples from 150 stations of lymph nodes, 2.4 puncture per station .The diagnostic sensitivity , specificity and accuracy were 93.02%, 100% and 93.62%, re-spectively .4 cases were clinically diagnosed as sarcoidosis , and 4 patients were clinically diagnosed as lymphnoditis . Conclusion EBUS-TBNA has higher sensitivity , specificity , accuracy and safety in diagnosis of mediastinal , hilar lymph node or the mass beside main trachea or bronchus and staging of lung cancer , and it is an economic and effec-tive diagnosis method .