电磁导航支气管镜在肺周围型病变诊断中的应用

Clinical applicaton of electromagnetic navigation bronchoscope in diagnosis of peripheral pulmonary lesion

目的探讨微创诊疗技术电磁导航支气管镜(ENB)活检在肺周围型病变(PPL)诊治中的应用。方法回顾性分析我院胸外科2016年6月至2017年12月施行ENB活检的29例PPL患者的临床资料。利用ENB进行术前病理活检及病变定位,根据定位在电视胸腔镜下对标记位置进行精准切除。结果每个病灶ENB活检取样3块,操作时间(31.2±6.5)min,术中失血量(4.1±1.6)mL。总体诊断率79.3%,肿瘤确诊率78.9%。ENB联合PET可使总体诊断率提升至86.2%。不同病灶大小、不同肺叶PPL活检成功率比较,差异无统计学意义(P>0.05)。操作过程中无气胸、大出血及气管损伤。结论利用ENB技术诊断PPL技术精度高,具有较高的阳性率,并发症发生率低,可一站式完成诊断及定位。

Objective To explore the clinical application of electromagnetic navigation bronchoscope(ENB)in the diagnosis and treatment of peripheral pulmonary lesion(PPL).Methods The clinical data of 29 patients with PPL who underwent ENB biopsy in our department from June 2016 to December 2017 were retrospectively analyzed.Preoperative pathological biopsy and lesion localization were performed by using ENB,and accurate resection of the marked sites was performed under video-assisted thoracoscopy according to the localization.Results Three ENB biopsies were taken for each lesion,the operation time was(31.2±6.5)minutes and the blood loss was(4.1±1.6)mL.The overall diagnostic rate was 79.3%,and the diagnostic rate of tumors was 78.9%.ENB combined with PET could increase the overall diagnostic rate to 86.2%.There was no significant difference in the success rate of PPL biopsy in different size of lesions and different lobes(P>0.05).There was no pneumothorax,massive hemorrhage and tracheal injury occurred during the operation.Conclusion ENB technology has a high positive rate and accuracy,low complication rate in the diagnosis of PPL,which can diagnose and locate for PPL in one-stop mode.