快速现场评估联合径向支气管超声肺活检对老年周围型肺部病变的诊断价值

doi:10.3969/j.issn.1003-9198.2024.07.010

摘要/Abstract

摘要： 目的探讨快速现场评估(ROSE)联合径向支气管超声肺活检(EBUS-TBLB)对老年病人周围型肺部病变(PPLs)的诊断价值。方法选择112例经胸部CT发现有未确诊的老年PPLs病人纳入本研究。所有病人均接受了EBUS-TBLB检查,并从每次操作中获得活检标本,进行ROSE,将ROSE诊断结果与最终病理诊断结果进行比较,记录ROSE阳性组及阴性组的操作时间、操作次数,分析ROSE联合EBUS-TBLB在老年病人PPLs诊断中的可行性和安全性。结果 ROSE联合EBUS-TBLB对老年病人PPLs的诊断准确度、敏感度和特异度分别为90.2%、86.7%和97.3%。ROSE阳性病人的活检次数和操作时间均少于ROSE阴性病人(P＜0.05)。所有病人均无严重的手术并发症发生。结论 ROSE联合EBUS-TBLB是一种安全有效诊断老年病人PPLs的方法。

关键词: 老年人, 径向支气管超声, 支气管肺活检, 快速现场评估, 周围型肺部病变

Abstract: Objective To explore the value of rapid on-site evaluation(ROSE) during radial probe endobronchial ultrasound transbronchial lung biopsy(EBUS-TBLB) for peripheral pulmonary lesions(PPLs) in the elderly patients. Methods A total of 112 elderly patients who presented with undiagnosed PPLs by computed tomography(CT) were enrolled in this study. All patients received EBUS-TBLB examination, and biopsy specimens obtained from each operation underwent ROSE operation. The ROSE results were compared with the final pathological results, and the number of biopsies and operating time in ROSE positive group and ROSE negative group were recorded and compared. The feasibility and safety of ROSE combined with EBUS-TBLB in the the elderly patients with PPLs were analyzed. Results The diagnostic accuracy, sensitivity and specificity of ROSE combined with EBUS-TBLB for PPLs in the elderly patients were 90.2%, 86.7% and 97.3%, respectively. The number of biopsies and operating time were lower in ROSE positive group than those in ROSE negative group(All P＜0.05). No serious operative complications were observed. Conclusions ROSE combined with EBUS-TBLB is a safe and effective method for diagnosing PPLs in the elderly patients.

Key words: aged, radial probe endobronchial ultrasound, transbronchial lung biopsy, rapid on-site evaluation, peripheral pulmonary lesions

中图分类号:

R 445.1

蒋婷, 李丽, 王燕. 快速现场评估联合径向支气管超声肺活检对老年周围型肺部病变的诊断价值[J]. 实用老年医学, 2024, 38(7): 688-692.

JIANG Ting, LI Li, WANG Yan. Diagnostic value of rapid on-site evaluation combined with radial probe endobronchial ultrasound transbronchial lung biopsy for peripheral pulmonary lesions in elderly patients[J]. Practical Geriatrics, 2024, 38(7): 688-692.

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