TBLB联合ROSE在冠心病合并周围型肺癌患者中的应用

Application of transbronchial lung biopsy combined with rapid onsite evaluation to coronary heart diseasepatients combined with peripheral lung cancer

目的探究经支气管镜肺活检术(TBLB)联合快速现场评估(ROSE)技术在冠心病合并周围型肺癌患者中的临床应用价值。方法本研究为观察性研究,采用非随机抽样的方法选取2021年4月至2023年4月首都医科大学附属北京安贞医院收治的冠心病合并周围型肺癌患者96例为研究对象。根据TBLB是否联合ROSE技术将患者分为ROSE组48例和常规组48例。比较2组患者首次活检确诊情况、钳取次数、操作时间、首次活检是否获得足够标本量和并发症情况。结果ROSE组首次活检确诊率高于常规组[87.5%(42/48)比70.8%(34/48)],差异有统计学意义(χ^(2)=4.04,P=0.044)。ROSE组钳取次数多于常规组[(7.27±1.20)次比(5.85±0.82)次],操作时间长于常规组[(37.83±2.44)min比(29.46±4.06)min],首次活检获得足够标本量者占比高于常规组[81.2%(39/48)比62.5%(30/48)],差异均有统计学意义(均P<0.05)。ROSE组和常规组患者气胸、出血、心律失常、低氧血症和心绞痛发生率比较,差异均无统计学意义(均P>0.05)。结论在冠心病合并周围型肺癌患者中采用TBLB联合ROSE技术能够提高首次活检确诊率并获得足够标本量,降低二次检查率,且具有良好的安全性。

Objective To explore the clinical application value of transbronchial lung biopsy(TBLB)combined with rapid onsite evaluation(ROSE)to coronary heart disease patients combined with peripheral lung cancer.Methods It was an observational study involving 96 coronary heart disease patients combined with peripheral lung cancer treated in Beijing Anzhen Hospital,Capital Medical University from April 2021 to April 2023.Subjects were selected by non-random sampling method.TBLB was performed in all patients.They were divided into ROSE group(n=48)and conventional group(n=48)based on the application of ROSE or not.The diagnostic rate by the first biopsy,biopsy frequency,bronchoscopic duration,enough samples for the first biopsy and the complications were compared between two groups.Results The diagnostic rate by the first biopsy in the ROSE group was significantly higher than that in the conventional group(87.5%[42/48]vs 70.8%[34/48],x^(2)=4.04,P=0.044).Patients in the ROSE group presented significantly higher biopsy frequency([7.27±1.20]s[5.85±0.82]),longer bronchoscopic duration([37.83±2.44]min us[29.46±4.06]min),and higher proportion of sufficient samples for the first biopsy(81.2%[39/48]vs 62.5%[30/48])than those in the conventional group(all P<0.05).The incidence rates of complications like pneumothorax,bleeding,arrhythmias,hypoxemia and angina pectoris were similar between the two groups(all P>0.05).Conclusions TBLB combined with ROSE technology is capable of effectively improving the diagnostic rate by the first biopsy,obtaining enough samples,lowering the secondary biopsy rate and obtaining satisfactory safety in coronary heart disease patients combined with peripheral lung cancer.