摘要
目的分析超声支气管镜引导下针吸活检(Endobronchial ultrasound-guided transbronchial needle aspiration,EBUS-TBNA)纵隔淋巴结诊断阳性率影响因素,以促进临床进一步提高EBUS-TBNA纵隔淋巴结的诊断阳性率。方法回顾性分析2018年5月~2019年10月期间行EBUS-TBNA纵隔淋巴结检查并最终确诊的264例患者的临床资料。采用χ2检验、二元多因素Logistic回归分析方法比较患者性别、年龄、属性、吸烟状况、麻醉方式(局部麻醉、无痛静脉麻醉)、穿刺淋巴结分布、穿刺淋巴结最大短径、穿刺淋巴结数目及操作者经验不同时EBUS-TBNA纵隔淋巴结诊断阳性率的差异,分析影响EBUS-TBNA纵隔淋巴结诊断阳性率的相关因素。结果264例患者中,192例患者通过EBUS-TBNA纵隔淋巴结活检得到阳性诊断结果,阳性诊断率为72.73%(192/264)。通过二元多因素Logistic回归分析各因素对EBUS-TBNA纵隔淋巴结诊断阳性率的影响,发现患者属性、麻醉方式、穿刺淋巴结最大短径和穿刺淋巴结数目是EBUS-TBNA纵隔淋巴结诊断阳性率的独立影响因素(OR=2.081、OR=3.074、OR=2.068、OR=2.611,P均<0.05)。结论EBUS-TBNA对纵隔淋巴结性质有较高诊断阳性率,住院患者、无痛静脉麻醉、穿刺淋巴结最大短径≥1 cm、穿刺淋巴结数目≥2个有助于提高诊断阳性率。
Objective To analyze the factors affecting the diagnosis rate of mediastinal lymph nodes by endobronchial ultrasound-guided transbronchial needle aspiration.Methods The clinical data of 264 patients who underwent EBUS-TBNA mediastinal lymph node examination from May 2018 to October 2019 were analyzed retrospectively.χ2 test and binary multivariate logistic regression analysis were used to compare the positive rate of EBUS-TBNA mediastinal lymph nodes in patients with different gender,age,attribute,smoking status,anesthesia mode,distribution of puncture lymph nodes,maximum transverse diameter of puncture lymph nodes,number of puncture lymph nodes and operator experience.The factors affecting the diagnosis positive rate of EBUS-TBNA mediastinal lymph node were analyzed.Results Among the 264 patients,192 were diagnosed by EBUS-TBNA mediastinal lymph node biopsy,and the positive rate was 72.73%(192/264).Through binary multivariate logistic regression analysis,it found that the patient’s attribute,anesthesia mode,the maximum short diameter of punctured lymph nodes and the number of punctured lymph nodes were the independent influencing factors of the positive rate of EBUS-TBNA mediastinal lymph nodes(OR=2.081,3.074,2.068,2.611;P all<0.05).Conclusion EBUS-TBNA has a high positive rate in the diagnosis of mediastinal lymph nodes.Inpatients,painless intravenous anesthesia,the maximum transverse diameter of puncture lymph nodes≥1 cm and the number of puncture lymph nodes≥2 are helpful to improve the positive rate.
作者
张亚肖
甄强
赵晓建
张冰
李辉贤
耿丽娜
ZHANG Ya-Xiao;ZHEN Qiang;ZHAO Xiao-Jian;ZHANG Bin;LI Hui-Xian;GENG Li-Na(Department of Thoracic Surgery,Shijiazhuang General Hospital,Shijiazhuang,Hebei 050000,China)
出处
《临床肺科杂志》
2021年第10期1535-1538,共4页
Journal of Clinical Pulmonary Medicine
