经电子纤维支气管镜活检术对老年患者呼吸系统肿块诊断结果分析

Diagnosis Analysis of the Electronic Fibre Bronchoscopy Biopsy for Elderly Patients with Respiratory System Tumor

目的:通过分析76例老年患者呼吸系统肿块经电子纤维支气管镜活检(支气管镜下透支气管壁穿刺活检)的病理结果,探讨并评价经电子纤维支气管镜活检对老年患者呼吸系统肿块的诊断价值。方法:选取2016年9月-2017年1月笔者所在医院76例经胸部CT检查扫描出呼吸系统软组织类肿块阴影,其具体性质未确定,行常规的纤维支气管镜检查未发现明显的外界压力性改变或支气管腔内肿块的老年患者作为研究组,再经电子纤维支气管镜活检术后,将组织涂片直接病理科送检;随机抽取经胸部CT检查后影像学表现相似的同期肿瘤且单纯行常规纤维支气管镜检查的74例老年患者设置为对照组。结果:研究组患者的阳性确诊率为89.47%,其最主要的合并症状是在支气管镜的穿刺点伴有少量出血,未发现明显的感染、呼吸系统气肿等严重并发症;对照组的阳性确诊率为28.37%,两组阳性确诊率比较差异有统计学意义(字2=23.685,P=0.002)。结论:经电子纤维支气管镜活检术是诊断老年患者呼吸系统肿物的有效手段,具有较高的临床诊断价值,其具阳性确诊率高,安全性好,特异性较强,创伤相对小的优点,值得在临床中进一步采用推广,但如何进一步提高其阳性检出率有待于继续深入探讨。

Objective： To analyze the 76 cases of elderly patients with respiratory system tumor via electronic fibre bronchoscopy biopsy pathology results, analyze and evaluate the diagnostic value of the electronic fibre bronchoscopy biopsy for elderly patients with respiratory system to assess tumor.Method： From September 2016 to January 2017, 76 cases with respiratory mass lesion in our hospital by chest CT examination showed, clinical diagnosis of properties to be determined, the conventional fiber bronchoseope examination without bronchial lumen lumps or only sex change lander external pressure of elderly patients as the experimental group, the electronic fibre bronchoscopy biopsy, direct smear inspection; while extracting the chest CT had the same tumor only conventional fiber bronchoscope examination of 74 cases of elderly patients as the control group.Result： The experimental group diagnosis positive rate was 89.47%, the main complications for the puncture point a small amount of bleeding, not present mediastinal emphysema and infection of the serious adverse reactions.The control group diagnosis positive rate was 28.37%, the diagnosis positive rate in two groups was significant（χ^2=23.685, P=0.002）.Conclusion： Electronic fibre bronchoscopy biopsy is an effective method for diagnosis of elderly patients with respiratory system neoplasm, has high diagnostic value, its diagnosis positive rate is high, small trauma, specificity is strong, the advantages of high safety, is worth popularizing further used in clinical, but how to further improve the positive detection rate to be discussed.