Chest:肺部病变活检时X线标准支气管镜检查与细支气管镜和支气管内径向超声的比较

2018-08-23 xiangting MedSci原创

细或非细支气管镜检查和R-EBUS对肺部病变的诊断率低。未来的工作应侧重于技术和科技的改进,以确保获得诊断的可能性更高。

新技术使得支气管镜检查越来越多地被应用于肺部病变的诊断,这些手术报告的检出率差异很大,几乎没有随机临床试验。这项研究比较了细支气管镜和支气管内径向超声(R-EBUS)与X线标准支气管镜检查(SB-F)对肺部病变的诊断率。

在五个中心接受诊断性支气管镜评估的患者被随机分为SB-F或细支气管镜R-EBUS(TB-EBUS)。如果SB-F无法诊断,则允许转为TB-EBUS组。收集患者的人口学、影像学特征以及最终的病理或影像学随访。使用Fisher平方、卡方检验和t检验进行统计学比较。进行双因素和多因素分析确定诊断率的预测因子。

最终分析共纳入197名患者。研究组间的人口学、病变大小或位置没有差异。平均病变大小为31.2mm(标准差10.8mm)。支气管镜检查诊断率为44%(n = 87)。虽然与SB-F组相比,TB-EBUS组的诊断率更高(49%vs 37%),但这种差异无统计学意义(p=0.11)。标准组支气管镜检查结果为非诊断性的患者中,87%(n=46)转为TB-EBUS,并使得7例额外患者(15%)得到诊断。

细或非细支气管镜检查和R-EBUS对肺部病变的诊断率低。未来的工作应侧重于技术和科技的改进,以确保获得诊断的可能性更高。

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    2019-07-12 Smile2680
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    2018-08-25 piaojinhua
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