摘要
目的研究LungPoint虚拟导航辅助支气管镜检查在肺外周结节诊断中的应用价值。方法纳入2017年4月~2018年7月,中国科学院大学深圳医院收治的肺外周结节患者264例作为研究对象。所有受试者均行LungPoint虚拟导航辅助支气管镜检查。术中导航成功后通过径向气道内超声探头确认位置,或有需要在X线透视下进行标本获取,送病理学检查.根据病理阳性率来确定LungPoint虚拟导航辅助支气管镜检查对肺外周结节的诊断价值。结果病理阳性结果囊括腺癌179例,鳞状细胞癌7例,肺小细胞癌11例,转移瘤5例,淋巴瘤3例,结核12例,炎症31例;另有38例病理结果阴性,其中17例手术病理确诊肺癌,8例手术病理为慢性炎,另外13例未作手术,予定期随访观察。LungPoint虚拟导航辅助支气管镜检查诊断肺外周结节患者的总体诊断阳性率为85.61%。LungPoint导航平均时间(6.84±2.12)min,LungPro导航平均时间(24.26±10.03)min。264例肺外周结节患者LungPoint虚拟导航辅助支气管镜检查诊断后出现11例气胸,发生率为4.17%,无大咯血、感染等并发症的发生,且气胸患者中9例经胸腔穿刺抽气或吸氧后好转,2例需胸腔闭式引流。结论LungPoint虚拟导航辅助支气管镜检查应用于肺外周结节诊断中的应用价值较高,可显著提高肺外周病变的诊断阳性率,同时有利于降低相关并发症的发生风险,安全性较好,值得临床推广应用。
Objective To study the value of LungPoint virtual navigation-assisted bronchoscopy in the diagnosis of peripheral pulmonary nodules.Methods 264 patients with peripheral pulmonary nodules admitted to Shenzhen hospital of University of Chinese Academy of Sciences from April 2017 to July 2018 were included as subjects.All subjects underwent LungPoint virtual navigation-assisted bronchoscopy.After successful intraoperative navigation,the position was confirmed by a radial airway ultrasound probe,or specimens were obtained under X-ray fluoroscopy for pathological examination.The diagnostic value of LungPoint virtual navigation-assisted bronchoscopy for peripheral pulmonary nodules was determined according to the pathological positive rate.Results The positive results included 157 cases of adenocarcinoma,7 cases of squamous cell carcinoma,11 cases of small cell lung carcinoma,5 cases of metastatic tumor,3 cases of lymphoma,12 cases of tuberculosis and 31 cases of inflammation.The overall positive rate of LungPoint virtual navigation-assisted bronchoscopy in diagnosing peripheral pulmonary nodules was 85.61%.The average LungPoint navigation time was(6.84±2.12)min,while the average LungPro navigation time was(24.26±10.03)min.After LungPoint virtual navigation-assisted bronchoscopy diagnosis,264 patients with peripheral pulmonary nodules presented pneumothorax in 11 cases,with an incidence of 4.17%.There was no major hemoptysis,infection or other complications,and 9 patients with pneumothorax improved after thoracopuncture or oxygen inhalation,while 2 patients required closed thoracic drainage.Conclusion LungPoint virtual navigation-assisted bronchoscopy is of high value in the diagnosis of peripheral pulmonary nodules,which can significantly improve the positive rate of diagnosis of peripheral pulmonary lesions,and help reduce the risk of related complications.Therefore,it is safe and worthy of clinical promotion and application.
作者
付鹏
黄文婷
龙发
龙亮
董洪波
甘景帆
蒋慧
FU Peng;HUANG Wen-ting;LONG Fa;LONG Liang;DONG Hong-bo;GAN Jing-fan;JIANG Hui(Department of Respiratory Medicine,Shenzhen Hospital(Guangming)of Chinese Academy of Sciences,Shenzhen,Guangdong 518106,China)
出处
《临床肺科杂志》
2020年第10期1462-1467,共6页
Journal of Clinical Pulmonary Medicine
关键词
虚拟导航
支气管镜检查
肺外周结节
病理组织活检
诊断价值
virtual navigation
bronchoscopy
peripheral pulmonary nodules
pathological biopsy
diagnostic value
