Lung-pro联合快速现场评估在周围型肺结节诊断中的作用

Role of Lung-pro Combined with Rapid on-site Evaluation in Diagnosis of Peripheral Pulmonary Nodules

目的探讨Lung-pro导航支气管镜技术联合快速现场评估(rapid on-site evaluation,ROSE)对周围型肺结节的诊断价值及优势。方法选取云南省肿瘤医院支气管内镜室2018年12月至2019年3月间胸部CT表现为周围型肺结节且行纤维支气管镜活检(transbronchial lung biopsy,TBLB)的患者112例,其中行传统支气管镜活检(C-TBLB)56例(C-TBLB组),行Lung-pro导航支气管镜同时行ROSE活检56例(Lung-pro组)。比较两组诊断率、病理学符合率及并发症的差异,评估Lung-pro导航支气管镜活检联合ROSE对周围型肺结节的诊断价值及优势。结果C-TBLB对周围型肺结节的诊断率为25.0%(14/56),Lung-pro组为76.8%(43/56),差异有统计学意义(P<0.01)。C-TBLB组活检病理与术后病理符合率为:34.6%(9/26),Lung-pro组为:84.6%(33/39),两组间差异显著(P<0.01)。两组患者术后均有不同程度痰中带血,C-TBLB组发生1例气胸(1/56),Lung-pro组发生2例气胸(2/56),差异无统计学意义(P>0.05)。结论Lung-pro导航支气管镜技术联合ROSE对肺周围型肺结节诊断率及与术后病理结果符合率均高于C-TBLB组,且并发症可控,值得临床推广。

Objectives To explore the diagnostic value and advantages of lung Pro navigation Bronchoscopy Combined with rapid field evaluation in diagnosis of peripheral pulmonary nodules.Me thods 112 patients with peripheral pulmonary nodules on chest CT from December 2018 to March 2019 in bronchoscope room of the Yunnan Tumor Hospital who underwent fibrobronchoscopy and ROSE were analyzed.They were randomly divided into traditional bronchoscope biopsy(C-TBLB)group and Lung-pro guided bronchoscope biopsy(Lung-pro)group,with 56 cases in each group.The diagnostic rate,complications and pathological coincidence rate of the two groups were compared to evaluate the diagnostic value of Lung-pro guided bronchoscopy biopsy combined with ROSE for peripheral pulmonary nodules.Re s ults The diagnostic rate of C-TBLB for peripheral pulmonary nodules was25.0%(14/56)and 76.8%(43/56)in Lung-pro group,the difference was statistically significant(P<0.01).Two groups of patients had different degrees of blood in sputum after operation.C-TBLB group:1 pneumothorax(1/56),Lung-pro group:2 pneumothorax(2/56),the difference was not statistically significant.The coincidence rate of biopsy pathology and postoperative pathology in C-TBLB group was 34.6%(9/26);The Lung-pro group was 84.6%(33/39),with significant difference between the two groups(P<0.01).The coincidence rate of biopsy pathology and postoperative pathology in C-TBLB group was 34.6%(9/26);The Lung-pro group was 84.6%(33/39),with significant difference between the two groups(P<0.01).Conclus ion Lung-pro navigation bronchoscopy combined with ROSE for peripheral pulmonary nodules has high diagnostic coincidence rate and one-time success rate,controllable complications,and is worthy of clinical promotion.