[1]张茜茜,安云霞,徐紫光,等.经支气管镜冷冻肺活检对弥漫性间质性肺疾病的诊断价值[J].新乡医学院学报,2018,35(5):389-392.[doi:10.7683/xxyxyxb.2018.05.008]
　ZHANG Qian-qian,AN Yun-xia,XU Zi-guang,et al.Efficiency of transbronchial lung cryobiopsy in diagnosis of diffuse interstitial lung disease[J].Journal of Xinxiang Medical University,2018,35(5):389-392.[doi:10.7683/xxyxyxb.2018.05.008]
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经支气管镜冷冻肺活检对弥漫性间质性肺疾病的诊断价值
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
35
期数:
2018年5
页码:
389-392
栏目:
临床研究
出版日期:
2018-05-05

文章信息/Info

Title:
Efficiency of transbronchial lung cryobiopsy in diagnosis of diffuse interstitial lung disease
作者:
张茜茜1; 安云霞1; 徐紫光2; 李晓亮1; 马　芸1
（1.河南省人民医院呼吸及危重症科，河南　郑州　450003；2.河南省人民医院病理科，河南　郑州　450003）
Author(s):
ZHANG Qian-qian1; AN Yun-xia1; XU Zi-guang2; LI Xiao-liang1; MA Yun1
（1.Department of Respiratory and Critical Care Medicine，Henan Provincial People′s Hospital，Zhengzhou 450003，Henan Province，China；2.Department of Pathology，Henan Provincial People′s Hospital，Zhengzhou 450003，Henan Province，China）
关键词:
支气管镜冷冻肺活检; 弥漫性间质性肺疾病; 诊断
Keywords:
transbronchial lung cryobiopsy; diffuse interstitial lung disease; diagnosis
分类号:
R563.9
DOI:
10.7683/xxyxyxb.2018.05.008
文献标志码:
A
摘要:
目的　评价经支气管镜冷冻肺活检（TBLC）对弥漫性间质性肺疾病的诊断价值。方法　选择2016年1月至2017年6月因胸部CT显示为双肺弥漫性肺疾病在河南省人民医院行TBLC且临床资料完整的41例患者为研究对象，回顾性分析所有患者的病史、肺功能、胸部高分辨CT及TBLC等检查结果。结果　41例患者共获取TBLC组织样本102个，平均直径（4.6±1.5）mm。25例（61.0%）获得明确病理形态学诊断，病理类型为机化性肺炎9例、间质性肺炎8例、非坏死性炎症性肉芽肿6例、侵袭性黏液腺癌1例、肺泡蛋白沉积症1例。16例（39.0%）未确定诊断，其中3例进一步经多学科会诊确立诊断。最终28例获得确诊，诊断阳性率为68.3%（28/41）。出血与气胸的发生率分别为51.2%（21/41）和9.8%（4/41）；出血患者和未出血患者活检标本直径分别为（5.5±1.5）、（5.0±1.9）mm，出血患者活检标本直径与未出血患者比较差异无统计学意义（t=0.87，P=0.388）；发生气胸患者和未发生气胸患者活检标本直径分别为（5.6±1.9）、（5.2±1.7）mm，发生气胸患者活检标本直径与未发生气胸患者比较差异无统计学意义（t=0.51，P=0.614）。结论　结合多学科会诊约70%的弥漫性间质性肺疾病经TBLC能够获得诊断。
Abstract:
Objective　To evaluate the efficiency of transbronchial lung cryobiopsy （TBLC） in diagnosis of diffuse interstitial lung disease（DILD）.Methods　A total of 41 patients with radiographic features of DILD underwent TBLC in Henan Provincial People′s Hospital from January 2016 to June 2017.The results of clinical data，radiological and TBLC were retrospectively analyzed.Results　One hundred and two samples were obtained from TBLC，with the mean diameter of （4.6±1.5）mm.Confirmed diagnosis by transbronchial lung cryobiopsy was obtained in 25 patients（61.0%）.The histopathologic patterns were organizing pneumonia（9 cases），interstitial pneumonia （8 cases），non-granuloma gangraenescens inflammation（6 cases） invasive mucinous adenocarcinoma(1 case),and pulmonary alveolar proteinosis(1 case).Sixteen cases （39.0%） with nonspecific histopathologic findings，three patients were definite diagnosed by a multidisciplinary approach.Finally,28 patients were diagnosed definitly,the positive diagnosis rate was 68.3%(28/41).The rate of bleeding and pneumothorax was 51.2% （21/41）and 9.8%（4/41），respectively.The diameter of biopsy specimen in the bleeding patients and non-bleeding patients was （5.5±1.5）and（5.0±1.9）mm，there was no significant difference in the diameter of biopsy specimen between the bleeding patients and non-bleeding patients（t=0.87，P=0.388）.The diameter of biopsy specimen in the pneumothorax patients and non-pneumothorax patients was （5.6±1.9） and （5.2±1.7）mm，there was no significant difference in the diameter of biopsy specimen between the pneumothorax patients and non-pneumothorax patients（t=0.51，P=0.614）.Conclusion　TBLC combination with multidisciplinary diagnosis can provide confirmed diagnosis in 70% patients with DILD.

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更新日期/Last Update: 2018-05-05