CAJ | 학술논문

目的观察超声引导下经支气管镜针吸活检(EBUS-TBNA)对结节病的诊断价值.方法回顾性分析2010年8月至2011年10月北京大学第一医院因不明原因纵隔淋巴结肿大行EBUS-TBNA的107例患者,其中17例确诊为结节病,其中男2例,女15例,年龄24 ～ 70岁,中位年龄55岁.比较常规支气管镜和EBUS-TBNA的诊断阳性率,观察穿刺针数和阳性率间的关系.结果经病理诊断确诊结节病的17例患者中,14例针吸涂片阳性;常规支气管镜检查阳性8例(8/17),常规支气管镜与EBUS-TBNA相结合共确诊15例患者.直径＜2 cm淋巴结穿刺阳性者3例,≥2 cm的淋巴结穿刺阳性者15例.每个淋巴结穿刺4针时细胞学检查结果与最终结果的符合率为100％.结论 EBUS-TBNA诊断结节病安全有效.对于怀疑结节病的患者需要选择肿大最明显的淋巴结进行穿刺,每个淋巴结穿刺4针可以得到足够的标本.
목적 관찰초성인도하경지기관경침흡활검(EBUS-TBNA)대결절병적진단개치.방법 회고성분석2010년8월지2011년10월북경대학제일의원인불명원인종격림파결종대행EBUS-TBNA적107례환자,기중17례학진위결절병,기중남2례,녀15례,년령24 ～ 70세,중위년령55세.비교상규지기관경화EBUS-TBNA적진단양성솔,관찰천자침수화양성솔간적관계.결과 경병리진단학진결절병적17례환자중,14례침흡도편양성;상규지기관경검사양성8례(8/17),상규지기관경여EBUS-TBNA상결합공학진15례환자.직경＜2 cm림파결천자양성자3례,≥2 cm적림파결천자양성자15례.매개림파결천자4침시세포학검사결과여최종결과적부합솔위100％.결론 EBUS-TBNA진단결절병안전유효.대우부의결절병적환자수요선택종대최명현적림파결진행천자,매개림파결천자4침가이득도족구적표본.
Objective The aim of this study was to observe the diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in sarcoidosis.Methods We retrospectively analyzed the diagnostic efficiency of standard bronchoscopy and EBUS-TBNA in all patients diagnosed as sarcoidosis in Peking University First Hospitals between August 2010 and October 2011.The relationship between biopsy puncture numbers and sensitivity was calculated.Results There were 17 sarcoidosis patients among a total of 107 patients who had received EBUS-TBNA.Forteen patients had a positive TBNA result and the sensitive of EBUS-TBNA was 82％.The sensitivity of standard brochoscopy was 53％ and when combined with EBUS-TBNA,the sensitivity increased to 88％.The sensitivity of EBUS-TBNA was associated with the size of lymph nodes.Lymph nodes with a diameter ≥2 cm showed a higher positive rate.Four punctures for 1 lymph node showed a concordance rate of 100％ with the final results.Conclusions EBUS-TBNA was a safe and effective method in diagnosing pulmonary sarcoidosis.For patients with suspected sarcoidosis EBUS-TBNA should be performed in the largest lymph nodes with at least 4 punctures.