经支气管镜针吸活检联合快速现场评价诊断纵隔病变18例及文献复习

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摘要目的探讨经支气管镜针吸活检（TBNA）联合快速现场评价（ROSE）技术对纵隔病变的诊断价值。方法选择2016年6月~2018年6月连云港市第一人民医院收治的18例纵隔病变患者，均行TBNA及ROSE技术检测。根据最终病理学检查结果，计算TBNA联合ROSE技术的诊断效能及与最终病理学检查诊断符合率，观察TBNA联合ROSE技术并发症的发生情况。结果 TBNA联合ROSE技术诊断纵隔病变的敏感度为70.6%，特异度为100.0%，阳性预测值为100.0%，阴性预测值为16.7%，漏诊率为29.4%，无一例误诊。TBNA联合ROSE技术与最终病理学检查诊断符合率为72.2%。并发症的发生情况为窦性心动过速2例，穿刺部位少量出血5例，声音嘶哑1例，无大咯血发生。结论 TBNA联合ROSE技术诊断纵隔病变具有较高的诊断效能，是一种有效减少二次TBNA的安全技术。

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	赵青1* 吴兴萍2* 梁程程2 张趁英2 史家欣2 李家树2

关键词 ：经支气管镜针吸活检, 快速现场评价, 纵隔, 淋巴结, 肺癌

Abstract：Objective To evaluate the diagnostic value of transbronchial needle aspiration (TBNA) combined with rapid on-site evaluation (ROSE) technique in mediastinal lesions. Methods Eighteen patients with mediastinal lesions from June 2016 to June 2018 in the First People′s Hospital of Lianyungang were selected, all the patients were given the detection of TBNA and ROSE technique. The diagnostic efficiency of TBNA combined with ROSE, and diagnose accordance rate with final pathological examination were calculated, the occurrence of complications of TBNA combined with ROSE technique were observed. Results The sensitivity of TBNA combined with ROSE technique in the diagnosis of mediastinal lesions was 70.6%, the specificity was 100.0%, positive predictive value was 100.0%, negative predictive value was 16.7%, miss rate was 29.4%, and no misdiagnosis patient. The diagnose accordance rate of BNA combined with ROSE technique and final pathological examination was 72.2%, the complications included 2 cases of sinus tachycardia, 5 cases of mild hemorrhage, and 1 case of hoarseness, no massive hemorrhage. Conclusion TBNA combined with ROSE technique has high diagnostic efficiency in diagnosing mediastinal lesions, which could significantly reduce repeated TBNA.

Key words： Transbronchial needle aspiration Rapid on-site evaluation Mediastinum Lymph node Lung cancer

基金资助:国家自然科学基金资助项目(81300052)；
江苏省青年医学重点人才资助项目(QNRC2016504)；
江苏省连云港市社会发展计划项目(SH1401)。

通讯作者: 李家树(1960-)，男，副教授，主任医师；研究方向：肺部肿瘤。史家欣(1979-)，男，副教授，副主任医师；研究方向：肺部炎症与肿瘤。

作者简介: *共同第一作者

引用本文:

赵青1* 吴兴萍2* 梁程程2 张趁英2 史家欣2 李家树2. 经支气管镜针吸活检联合快速现场评价诊断纵隔病变18例及文献复习[J]. 中国医药导报, 2019, 16(25): 153-157.
ZHAO Qing1* WU Xingping2* LIANG Chengcheng2 ZHANG Chenying2 SHI Jiaxin2 LI Jiashu2. The transbronchial needle aspiration combined with rapid on-site evaluation in diagnosis of 18 cases with mediastinal lesions and literature review. 中国医药导报, 2019, 16(25): 153-157.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2019/V16/I25/153

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