摘要
目的研究分析经支气管内超声引导针吸活检术(EBUS-TBNA)中使用21G与22G两种不同型号穿刺针对纵隔淋巴结肿大诊断结果的影响。方法回顾性分析155例肺癌患者的临床资料,所有患者均行EBUS-TBNA检查其是否存在纵隔淋巴结肿大,其中84例患者使用21G穿刺针,71例患者使用22G穿刺针,分析比较患者采用两种型号穿刺针穿刺的结果。结果155例患者经过EBUS-TBNA证实阳性患者108例,阴性患者47例,所有患者均耐受良好,术中及术后均未出现明显并发症。阳性患者中58例使用21G穿刺针,50例使用22G穿刺针;阴性患者中26例使用21G穿刺针,21例使用22G穿刺针。阳性患者均通过后续治疗或病情进展证实为纵隔淋巴结肿大;阴性患者均进一步行胸腔镜肺叶(或袖式)切除及纵隔淋巴结清扫术,术后经病理证实42例为阴性,5例有纵隔淋巴结肿大(假阴性)。5例假阴性患者中2例使用21G穿刺针,3例使用22G穿刺针。21G和22G穿刺针诊断准确率分别为97.6%(82/84)和95.8%(68/71),比较差异无统计学意义(P>0.05)。结论在以EBUS-TBNA诊断肺癌纵隔淋巴结肿大中,使用21G及22G穿刺针均具有较高的准确率,两种不同型号穿刺针的选择对穿刺结果无影响。
Objective To study and analyze the effect of different types of 21 G and 22 G puncture needles on the diagnostic results of mediastinal lymphadenopathy in endobronchial ultrasound-guided transbronchial needle aspiration(EBUS-TBNA).Methods The clinical data of 155 patients with lung cancer were analyzed retrospectively.EBUS-TBNA was performed in all patients to check whether there was mediastinal lymphadenopathy.Among them,84 patients used 21 G puncture needle and 71 patients used 22 G puncture needle.The results of two types of puncture needle were analyzed and compared.Results There were 108 positive cases and 47 negative cases in 155 patients confirmed by EBUS-TBNA.All patients were well tolerated and no obvious complications occurred during and after operation.Among the positive patients,58 cases used 21 G puncture needle,50 cases used 22 G puncture needle;among the negative patients,26 cases used 21 G puncture needle,21 cases used 22 G puncture needle.All the positive patients were confirmed to be mediastinal lymphadenopathy by follow-up treatment or disease progression;all the negative patients were further treated with thoracoscopic(or sleeve type)lobectomy and mediastinal lymphadenectomy,42 cases were confirmed to be negative by pathology,of which 5 cases had mediastinal lymphadenopathy(false negative).In 5 false negative patients,2 cases used 21 G puncture needle and 3 cases used 22 G puncture needle.The diagnostic accuracy of 21 G and 22 G puncture needles was 97.6%(82/84)and 95.8%(68/71)respectively,and the difference was not statistically significant(P>0.05).Conclusion During the diagnosis of mediastinal lymphadenopathy by EBUSTBNA in lung cancer patients,Both 21 G and 22 G puncture needles have high accuracy,and the selection of two different types of puncture needles have no effect on the puncture results.
作者
辛兴
陈应泰
李凤卫
岳超
XIN Xing;CHEN Ying-tai;LI Feng-wei(Department of Thoracic Surgery,Beijing Aerospace General Hospital,Beijing 100076,China)
出处
《中国实用医药》
2019年第33期22-24,共3页
China Practical Medicine
关键词
支气管内超声引导针吸活检术
纵隔淋巴结肿大
穿刺针
肺癌
Endobronchial ultrasound-guided transbronchial needle aspiration
Mediastinal lymphadenopathy
Puncture needles
Lung cancer
