摘要
目的探讨径向超声支气管镜联合虚拟导航系统对肺周围型病变的诊断价值及安全性研究,为临床上选择PPLs的诊断方式提供依据。方法收集本院经胸部CT检查提示肺周围型病变患者500例,根据操作方式不同分为常规支气管镜组、VBN-rEBUS组、CT-PTNB组。分析比较三种诊断方式对PPLs的诊断阳性率及安全性。结果1.常规支气管镜组诊断率43.6%,其中恶性病变52例,良性病变共44例;VBN-rEBUS组诊断率60.8%,恶性病变55例,良性病变49例;CT-PTNB组诊断率76.1%,恶性病变60例,良性病变23例;VBN-rEBUS组、CT-PTNB组诊断率高于常规支气管镜组,CT-PTNB组诊断率高于VBN-rEBUS,差异有统计学意义(P均<0.05)。2.对于病灶直径≤3cm、距离胸壁<2cm、位于肺野中带的病灶,CT-PTNB诊断率高于常规支气管镜及VBN-rEBUS(P均<0.05),对于病灶直径>3cm、距离胸壁≥2cm、位于双肺上叶、下叶、右肺中叶及肺野内带及外带的病灶,VBN-rEBUS诊断率与CT-PTNB无显著差异。3.CT-PTNB并发症高于支气管镜及VBN-rEBUS,VBN-rEBUS高于支气管镜,差异具有统计学意义(P均<0.05)。结论VBN联合rEBUS用于诊断PPLs是安全有效的,尤其对于直径>3cm、距离胸壁≥2cm、位于肺野内带及外带的病灶,更有优势。
Objective To investigate the diagnostic value and safety of radial ultrasound bronchoscopy combined with virtual navigation system for peripheral pulmonary lesions(PPLs),and to provide a basis for the clinical selection of diagnostic modalities for PPLs.Methods A total of 500 patients with peripheral pulmonary lesions indicated by chest CT examination were collected and divided into routine bronchoscopy group,VBN-rEBUS group,and CT-PTNB group according to different operation methods.The positive rate and safety of three diagnostic methods for PPLs were analyzed and compared.Results 1.The diagnosis rate of the conventional bronchoscopy group was 43.6%,including 52 cases of malignant lesions and 44 cases of benign lesions;the diagnosis rate of the VBN-rEBUS group was 60.8%,with 55 cases of malignant lesions and 49 cases of benign lesions;the diagnosis rate of the CT-PTNB group was 76.1%,with 60 cases of malignant lesions and 23 cases of benign lesions;the diagnosis rates of the VBN-rEBUS and CT-PTNB groups were higher than those of the conventional bronchoscopy group,and the diagnosis rate of CT-PTNB group was higher than that of VBN-rEBUS,and the difference was statistically significant(all P<0.05).2.For lesions≤3 cm,<2 cm from the chest wall,located in the middle band of the lung field,the diagnostic rate of CT-PTNB was higher than that of conventional bronchoscopy and VBN-rEBUS(all P<0.05),and for lesions>3 cm,≥2 cm from the chest wall,located in the lower lobes and upper lobes of both lungs,the middle lobe of the right lung and the inner and outer bands of the lung field,the diagnostic rate of VBN-rEBUS was not significantly different from that of CT-PTNB difference.3.CT-PTNB complications were higher than bronchoscopy,VBN-rEBUS,and VBN-rEBUS were higher than bronchoscopy,with statistically significant differences(P<0.05).Conclusion VBN combined with rEBUS is safe and effective for the diagnosis of PPLs,especially for lesions>3 cm in diameter,≥2 cm from the chest wall,and located in the inner and outer ba
作者
周明婷
申怡
张先明
ZHOU Mingting;SHEN Yi;Zhang Xianming(Department of Respiratory and Critical Care Medicine,Affiliated Hospital of Guizhou Medical University,Guiyang,Guizhou 550004,China)
出处
《临床肺科杂志》
2023年第9期1310-1316,共7页
Journal of Clinical Pulmonary Medicine
基金
贵州省科技厅科技支撑计划项目(No.黔科合支撑[2021]一般061)
贵州省卫健委科技基金(No.gzwkj2021-090)。
关键词
虚拟导航支气管镜
气道内径向超声
支气管镜肺活检
经皮肺穿刺
肺周围型病变
诊断率
Virtual navigation system
airway radial ultrasound
bronchoscopic lung biopsy
percutaneous lung puncture
peripheral pulmonary lesions
diagnostic rate
