径向超声、虚拟导航、超细支气管镜联合评价对肺外周结节的诊断价值

Diagnosti value of joint evaluation of radial ultrasound,virtual navigation and ultrathin bronchoscope in peripheral pulmonary nodules

目的探讨径向超声(EBUS)联合虚拟导航(VBN)对肺外周结节的诊断价值。方法纳入2014年7月至2015年7月就诊唐都医院呼吸科的肺外周结节病变患者240例(0.8cm<直径<3cm),根据引导设备不同,分为径向超声联合虚拟导航组(EBUS+VBN组)、径向超声组(EBUS组)、虚拟导航组(VBN组)和对照组,分别行4组间诊断率的比较及病变不同大小时诊断率的比较,EBUS+VBN组与EBUS组定位病变时间及操作时间的比较。结果 240例患者中,EBUS+VBN组诊断率最高(81.67%),4组间诊断率差异有统计学意义(χ~2=19.34,P=0.00);EBUS+VBN组、EBUS组在直径小于或等于2cm的病灶中诊断率低于直径大于2cm的病灶,但差异无统计学意义(χ~2=2.04、3.40,P=0.15、0.07);EBUS+VBN组较EBUS组定位病变时间及操作时间均短,且差异无统计学意义(P=0.03、0.04)。结论径向超声联合虚拟导航可提高肺外周结节的诊断率,缩短定位病变时间及操作时间。

Objective To explore the diagnostic value of radial ultrasound （EBUS） combined with virtual navigation （VBN） in peripheral pulmonary nodules. Methods Two hundreds and forty cases of peripheral pulmonary nodules（0. 8 cm≤diameter≤3 cm） in the respiratory department of our hospital from July 2014 to July 2015 were included and according to the different guide de- vices, which were divided into the radial ultrasound combined with virtual navigation group （EBUS＋VBN group）, radial ultrasound group （EBUS group）, virtual navigation group fVBN group） and control group. The diagnostic rates were compared among the four groups and among di{ferent sizes of lesion. The time of lesion location and operating time were also compared between the EBUS＋ VBN group and EBUS group. Results Among 240 cases,the diagnostic rate in the EBUS＋VBN group was highest（81.67%） ,and the diagnostic rates had statistically significant difference among the four groups （x2 =19.34,P=0.00） ;the diagnostic rates of le- sions less than 2 cm in diameter were lower than that of lesions 〉2 cm in the EBUS＋VBN group and EBUS group, but without statistically significant difference （x2= 2.04,3.40, P=0.15,0.07） ;the locating lesions time and operating times in the EBUS＋ VBN group were shorter than those in the EBUS group, but the differenee between them was not statistically significant （P= 0.03, 0.04） . Conclusion EBUS combined with VBN could improve the diagnostic rate of peripheral pulmonary nodules and shorten the time of lesion location and operating time.