超声内镜引导下穿刺诊断肺部外周病灶

Endoscopic ultrasound-guided puncture for diagnosis of peripheral pulmonary lesions

目的探究超声内镜引导下穿刺诊断肺部外周病灶的效果。方法选取2013年2月至2016年2月于我院收治的84例肺部病变患者作为研究对象,运用随机数表法将患者分为A组与B组,每组各42例,A组用普通内镜根据CT影像进行检查穿刺,B组用电子支气管镜根据超声探测的病灶进行检查穿刺。统计诊断后两组周围型肺癌、肺结核瘤、肺炎性假瘤、肺炎性实变、胸膜间皮瘤病症的例数,气胸、咯血等并发症的例数以及并发症发生率、不同病灶大小的诊断成功率。结果 A组对周围型肺癌、肺结核瘤、肺炎性假瘤、肺炎性实变、胸膜间皮瘤的诊出率分别为72%、64%、68%、77%、82%;B组分别为53%、52%、60%、58%、64%,差异具有统计学意义(P<0.05)。在诊断过程中出现的并发症,B组出现气胸、咯血、针道转移例数分别为3例、2例1例,总的并发症发生率为7.1%;A组分别为4例、3例、3例,并发症发生率为11.9%,B组并发症发生率明显低于A组,差异具有统计学意义(P<0.05)。B组对各病灶总体诊断成功率为92%,明显高于A组的72%。二者比较差异具有统计学意义(P<0.05)。结论采用电子支气管镜超声检查穿刺的方法诊断肺部外周病灶,诊断成功率高、并发症较少,对人机体伤害小,应用价值高。

Objective To explore the effect of ultrasonography in the diagnosis of peripheral pulmonary lesions. Methods 84 patients with pulmonary lesions were selected from February 2013 to February 2016 in our hospital as the research object,and they were randomly divided into the A group and the B group,42 cases in each group,The A group was given ordinary endoscopic examination and puncture according to CT image,and the B group was given electronic bronchoscopy according to ultrasonic detection lesions puncture puncture. The cases of peripheral lung cancer,tuberculoma,inflammatory pseudotumor,inflammatory consolidation and pleural mesothelioma were recorded,and the complications such as pneumothorax and hemoptysis and different tumor sizes were observed too. Results The diagnostic rate of peripheral lung cancer,pulmonary tuberculoma,inflammatory pseudotumor,inflammatory consolidation and pleural mesothelioma was 72%,64%,68%,77% and 82% in the group A,and 53%,52%,60%,58% and 64% in the group B( P < 0. 05). There were 3 cases of pneumothorax,2 cases of hemoptysis and 1 case of needle tract metastasis,and the total complication rate was 7. 1% in the group B. There were 4 cases of pneumothorax,3 cases of hemoptysis and 3 cases of needle tract metastasis,and the total complication rate was11. 9% in the group A. The rate of complications was significantly lower in the group B than in the group A( P <0. 05). The overall success rate of the B group was 92%,which was significantly higher than 72% in the group A( P < 0. 05). Conclusion The diagnosis of peripheral pulmonary lesions by means of electronic bronchoscope ultrasound puncture diagnosis has higher diagnostic success rate,less complications and harm to human body.