【摘要】：目的評(píng)價(jià)國(guó)產(chǎn)電磁導(dǎo)航支氣管鏡(electromagnetic navigation bronchoscopy,ENB)檢查定位系統(tǒng)引導(dǎo)經(jīng)支氣管鏡肺活檢術(shù)(transbronchial lung biopsy,TBLB)在肺外周病灶診斷中的價(jià)值和安全性。方法收集2014年7月至12月來(lái)復(fù)旦大學(xué)附屬中山醫(yī)院就診、胸部螺旋CT顯示為肺外周病變的患者64例�；颊唠S機(jī)分入試驗(yàn)組和對(duì)照組,試驗(yàn)組ENB聯(lián)合X線透視下行TBLB,對(duì)照組行X線透視下TBLB。根據(jù)外科手術(shù)切除病灶的病理檢查結(jié)果或隨診24個(gè)月觀察臨床治療反應(yīng)及病情變化進(jìn)行最后確診。同時(shí)觀察和比較兩組病灶的檢查時(shí)間及術(shù)中術(shù)后不良事件發(fā)生情況。結(jié)果 64例患者共70處病灶。兩組病灶在患者年齡、性別、病灶大小、病灶部位方面的差異均無(wú)統(tǒng)計(jì)學(xué)意義。試驗(yàn)組肺活檢組織病理結(jié)果與最終診斷符合率為88.6%,對(duì)照組為62.9%,差異有統(tǒng)計(jì)學(xué)意義(P=0.012)。亞組分析顯示:病灶長(zhǎng)徑≤2 cm時(shí),試驗(yàn)組確診率(66.7%vs.20.0%)與對(duì)照組差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.266);2 cm病灶長(zhǎng)徑≤3 cm時(shí),兩組確診率差異無(wú)統(tǒng)計(jì)學(xué)意義(100%vs.81.8%,P=0.485);病灶長(zhǎng)徑3 cm時(shí),兩組確診率差異有統(tǒng)計(jì)學(xué)意義(94.4%vs.63.1%,P=0.042)。試驗(yàn)組的平均總檢查時(shí)間為(966±372)s,對(duì)照組為(1 040±470)s,差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.600);試驗(yàn)組尋找病灶所需X線透視時(shí)間為(7.0±4.8)s,對(duì)照組為(37.0±37.5)s,差異有統(tǒng)計(jì)學(xué)意義(P=0.008)。本研究中未發(fā)生氣胸、嚴(yán)重出血等不良事件。結(jié)論對(duì)于肺外周病灶,與傳統(tǒng)X線透視下TBLB相比,國(guó)產(chǎn)ENB檢查定位系統(tǒng)引導(dǎo)TBLB減少尋找病灶所需X線透視時(shí)間、提高病灶組織活檢病理診斷正確率,尤其在病灶長(zhǎng)徑3 cm時(shí)具有優(yōu)勢(shì),且具有一定的安全性。
[Abstract]:Objective to evaluate the value and safety of (electromagnetic navigation bronchoscopy endoscopy (electromagnetic navigation bronchos copy Enb) in the diagnosis of peripheral pulmonary lesions. Methods from July to December, 2014, 64 patients with peripheral pulmonary lesions were selected from Zhongshan Hospital affiliated to Fudan University. The patients were randomly divided into the trial group and the control group. The ENB combined with X-ray fluoroscopy was used in the test group and the control group was treated with the X-ray fluoroscopy. The final diagnosis was made on the basis of the pathological findings of surgical resection of the lesions or 24 months follow-up observation of the clinical response and the changes of the disease. At the same time, the time of examination and the occurrence of adverse events in operation and postoperative were observed and compared between the two groups. Results there were 70 lesions in 64 patients. There was no significant difference in age, sex, size and location of lesions between the two groups. The coincidence rate between pathological results of lung biopsy and final diagnosis was 88.6 in the test group and 62.9 in the control group (P < 0.012). The results of subgroup analysis showed that when the lesion diameter 鈮，

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