摘要
目的探讨支气管内超声引导针吸活检术（EBUS—TBNA）在诊断上腔静脉阻塞综合征（SVCS）中的应用价值。方法回顾性分析520例中20例SVCSEBUS—TBNA术患者的临床资料，男14例，女6例；年龄35～77岁，平均（59．1±14．6）岁。上腔静脉周围病变短径1．69～9．50em，平均（3．32±1．79）em，其中6例隆凸下淋巴结肿大，短径1．73—3．01em，平均（2．14±0．49）em。结果每例穿刺3～5次，平均（4．35±0．75）次。术后病理证实小细胞癌10例，腺癌4例，鳞癌1例，霍奇金淋巴瘤1例。4例穿刺病理未发现恶性证据，其中1例穿刺获取组织量少，2例术前CT显示纵隔占位内有明显钙化考虑良性可能性较大，此3例获取标本抗酸染色及结核分枝杆菌荧光扩增试验阴性，考虑为纵隔炎性病变；另1例因纵隔肿物巨大高度怀疑恶性肿瘤，故而进一步行胸腔镜胸腔活检术，术后病理证实为B细胞源性非霍奇金淋巴瘤。本组EBUS—TBNA对于SVCS病因的诊断率为90．0％（18／20）。结论EBUS．TBNA是诊断SVCS病因的一种安全有效的方法。
Objective To introduce our experience in the etiologic diagnosis of superior vena cava obstruction syndrome （SVCS） by endobronehial ultrasoundguided transbronchial needle aspiration （EBUSTBNA）. Methods The data of 520 pa tients who underwent EBUSTBNA from September 2009 to May 2012 in our institution were retrospectively reviewed. Among these patients,there were 14 males and 5 females who had SVCS with an average age of 59.1 years. Results The average short axis diameter of the paratracheal lesions was （ 3.32 ±1.79 ） cm （ ranged 1.69 - 9.50 cm） , and 6 cases also had subeari nal lymph node enlargement with an average short axis diameter of （ 2.14 ±0.49 ） cm （ ranged 1.73- 3.01 em）. And 4.3 punctures were performed per lesion. Malignancy was confirmed in 16 cases, including 10 small cell earcinoma, 4 adenoearci noma, 1 squamous cell carcinoma and 1 Hodgkin lymphoma. Two patients obtained enough tissue but no malignant evidence occurred. Beeause CT scan showed calcification in the lesions, probabilities of benign lesions were considered. There were no progresses during 13 to 24 months＂ followup. There was one patient who failed to get adequate tissue refused to receive further surgical biopsy since he had undergone endovascular stenting of SVC. The other undiagnosed ease was underwent thoracoseopic biopsy for the lesion was so huge and B cell nonHodgkin lymphoma was confirmed postoperatively. The diagnosis accuraey of EBUSTBNA in SVCS was 90.0% （18/20）. Conclusion EBUSTBNA is a highly effective and safe procedure in the etiolog ical diagnosis of SVCS.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2013年第7期405-407,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
关键词
支气管内超声
经支气管针吸活检
上腔静脉阻塞综合征
诊断
Endobronchial ultrasound Transbronchial needle aspiration Superior vena cava syndromeDiagnosis
