手绘导航在肺外周结节患者行支气管镜肺活检中的应用效果分析

Effect Analysis of Hand-Drawn Navigation in Bronchoscopic Lung Biopsy in Patients with Peripheral Pulmonary Nodules

目的:探讨手绘导航在肺外周结节患者行支气管镜肺活检中的应用价值及其对支气管镜到达活检部位时间的影响因素。方法:回顾性分析2022年8月—2023年3月在宜昌市中心人民医院呼吸内镜中心接受径向超声引导下经支气管镜肺活检的116例肺外周结节患者,根据术前是否采用手绘导航规划路径,分为手绘导航联合径向超声组(手绘导航+RP-EBUS-GS组,n=60)和径向超声组(RP-EBUS-GS组,n=56),对比分析手绘导航在支气管镜肺活检中的应用效果。采用单因素及多因素Logistic回归分析手绘导航对支气管镜到达活检部位时间的影响因素。结果:手绘导航+RP-EBUS-GS组支气管镜到达活检部位时间明显短于RP-EBUS-GS组(6.32±3.10 min vs 8.89±4.09 min,P<0.001)。以支气管镜到达活检部位时间为因变量,单因素分析结果显示,两组患者性别、结节与支气管关系、所在支气管分级及是否应用手绘导航有明显差异(均P<0.05);多因素Logistic结果显示,所在支气管分级及是否应用手绘导航是支气管镜到达活检部位时间的独立影响因素(均P<0.05)。结论:手绘导航在肺外周结节患者行支气管镜肺活检中可明显缩短支气管镜到达活检部位的时间,具有很好的临床应用价值。肺外周结节所在支气管分级及是否应用手绘导航是支气管镜到达肺活检部位时间的独立影响因素。

Objective:To explore the application value of hand-drawn navigation in bronchoscopic lung biopsy for patients with peripheral pulmonary nodules and the influence factors of the time for bronchoscope to reach the biopsy site.Methods:A retrospective analysis was conducted on 116 patients with peripheral pulmonary nodules who underwent radial probe endobronchial ultrasound-guided bronchoscopic lung biopsy at the Respiratory Endoscopy Center of Yichang Central People's Hospital from August 2022 to March 2023.They were divided into the hand-drawn navigation combined with radial probe endobronchial ultrasound group(hand-drawn navigation+RP-EBUS-GS group,n=60)and the radial probe endobronchial ultrasound group(RP-EBUS-GS group,n=56)according to whether hand-drawn navigation was used to plan the path before surgery.The application effect of hand-drawn navigation in bronchoscopic lung biopsy was comparatively analyzed.Univariate and multivariate Logistic regression analysis were used to analyze the influence of handdraw navigation in the time for bronchoscope to reach the biopsy site.Results:The time for bronchoscope to reach the biopsy site in the hand-drawn navigation+RP-EBUS-GS group was significantly shorter than that in the RP-EBUS-GS group(6.32±3.10 min vs 8.89±4.09 min,P<0.001).Taking the time for bronchoscope to reach the biopsy site as the dependent variable,the results of univariate analysis showed significant differences in gender,relationship between nodules and bronchi,bronchus grading,and whether hand-drawn navigation was used between the two groups(all P<0.05).Multivariate Logistic regression analysis showed that bronchus grading and the use of hand-drawn navigation were independent influencing factors for the time for bronchoscope to reach the biopsy site(both P<0.05).Conclusion:Hand-drawn navigation can significantly shorten the time for bronchoscope to reach the biopsy site for patients with peripheral pulmonary nodules,and it has good clinical application value.The bronchus grading of peripheral pulmonary nodules and whether hand-drawn navigation is used are independent influencing factors for the time for bronchoscope to reach the biopsy site.