超声支气管镜引导下经支气管针吸活检术在纵隔病变中的诊断意义

江洪; 王盈; 王浩

doi:10.13898/j.cnki.issn.2097-5252.2025.07.016

超声支气管镜引导下经支气管针吸活检术在纵隔病变中的诊断意义

Diagnostic significance of endobronchial ultrasound-guided transbronchial needle aspiration in mediastinal lesions

摘要

摘要:
目的探讨超声内镜引导下经支气管针吸穿刺活检术(EBUSTBNA)在纵隔病变中的诊断价值。
方法回顾性收集因纵隔病变行EBUS-TBNA检查病人249例临床资料，并通过EBUS-TBNA取得标本进行病理学检查。
结果病人均通过EBUS-TBNA获得组织病理学标本，样本获得成功率为100%。其中恶性病变100例(40.2%)，良性病变92例(36.9%)，未明确诊断57例(22.9%)。EBUSTBNA准确度为81.5%(203/249)，灵敏度为68.5%(100/146)，特异度为100%(103/103)，阳性预测值为100%(100/100)，阴性预测值为69.1%(103/149)，诊断率为77.1%(192/249)。仅1例病人穿刺过程中出现明显出血，予以局部止血后出血停止，其余病人在穿刺时及穿刺后均未出现严重并发症。
结论在纵隔疾病诊断中，EBUS-TBNA准确度高且较安全，临床可广泛使用。

Abstract:
Objective To investigate the diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in mediastinal lesions.
Methods The clinical data of 249 patients undergoing EBUS-TBNA examination for mediastinal lesions were retrospectively collected, and pathological examination of specimens obtained through EBUS-TBNA was conducted.
Results All patients obtained histopathological specimens by EBUS-TBNA, with a 100% success rate of sample acquisition.There were 100 cases (40.2%) of malignant lesions, 92 cases (36.9%) of benign lesions, 57 cases (22.9%) of undiagnosed lesions.The accuracy of EBUS-TBNA was 81.5% (203/249), sensitivity was 68.5% (100/146), specificity was 100% (103/103), positive predictive value was 100% (100/100), negative predictive value was 69.1% (103/149), and diagnosis rate was 77.1% (192/249).Only one patient experienced significant bleeding during the puncture process, which stopped after local hemostasis, and no other patients experienced severe complications during or after the puncture.
Conclusions In the diagnosis of mediastinal diseases, EBUS-TBNA is accurate and safe, and can be widely used in clinical practice.

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