摘要
目的:探讨支气管内超声引导下经支气管针吸活检术(EBUS-TBNA)在上腔静脉综合征(SVCS)病因诊断中应用的可行性及价值。方法:选取接受EBUS-TBNA检查的17例初诊SVCS患者作为研究对象。采用Kishi评分系统评估其SVCS的严重程度。以最终病理诊断为金标准,结合其临床资料,对EBUS-TBNA在SVCS患者病因学诊断中的适用范围、效果及安全性做出评价。结果:17例患者共穿刺25个部位(包括右侧气管旁17个,隆突下5个,右侧肺门3个),各部位穿刺次数为1～3次,患者平均操作时间为(14.76±3.82)min。患者术前Kishi评分为2～6。术后30min时所有患者的Kishi评分与术前相同。16例(94.1%)通过EBUS-TBNA获得了恶性病理确诊,其中肺癌15例(88.2%),包括鳞癌2例,腺癌4例,小细胞癌9例;1例患者(5.9%)为无法确定来源的低分化癌。在EBUS-TBNA操作过程中,除3例(17.7%)患者需短暂提高吸氧流量外,未发生活动性出血、气胸等严重并发症。结论:对于SVCS患者,EBUS-TBNA可作为一种安全、可靠的微创病因诊断方法。
OBJECTIVE： To evaluate the feasibility and efficacy of endobronchial ultrasound-guided transbronehial needle aspiration （EBUS-TBNA） in patients with superior vena eava syndrome （SVCS）. METHODS： Seventeen consecu- tive cases presented with SVCS were enrolled in this study. The severity of SVCS was graded with Kishi system. EBUS- TBNA was performed under local anesthesia. The clinical data and the final pathologic diagnosis of the 17 patients were e- valuated. RESULTS： Totally 25 procedures of EBUS-TBNA were performed in 17 patients （17 beside right windpipe, 5 under knuckle,3 at right hilus of the lung）. A median of 2 aspirations were done in each station （range 1-3）. The mean time of the procedures was （14.76~3.82） rain. According to the Kishi system,all the 17 patients scored from 2 to 6 be- fore EBUS-TBNA was performed. When the procedures were done only 3 patients showed slight score elevate, but re- stored quickly after a rest for 30 minutes. Malignancy was confirmed with EBUS-TBNA in 16 out of 17 （94.1 %） patients （including 9 small cell carcinoma, 4 adenocarcinoma, 2 squamous cell carcinoma and 1 poorly differentiated carcinoma） presented with SVCS,while one had a false negative result who required further mediastinoscopy. There was no major complication such as significant bleeding or pneumothorax related to the procedures,except temporarily increased oxygen supplement was needed in 3 （17.7%） patients. CONCLUSION： EBUS-TBNA can be a safe procedure with a high diag- nostic yield in SVCS patients.
出处
《中华肿瘤防治杂志》
CAS
北大核心
2013年第10期768-771,共4页
Chinese Journal of Cancer Prevention and Treatment
关键词
上腔静脉综合征
支气管内超声引导下经支气管针吸活检术
肺癌
纵隔淋巴结肿大
superior vena cava syndrome
endobronchial ultrasound-guided transbronchial needle aspiration
lung cancer
mediastinal lumphadenopathy
