支气管内超声引导针吸活检术(EBUS-TBNA)在胸内淋巴结结核诊断中的应用价值

摘要

目的 探讨支气管内超声引导针吸活检术(EBUS-TBNA)在胸内淋巴结结核诊断中的应用价值.方法 回顾性总结2009年9月至2012年9月接受EBUS-TBNA检查并最终明确诊断为胸内淋巴结结核的38例患者临床资料.患者术前胸部增强CT检查均发现肺门和(或)纵隔淋巴结肿大(≥10 mm),对于EBUS-TBNA未能明确诊断的患者,进一步接受外科手术活检.术后均接受至少6个月以上的临床及影像学随诊.结果 38例患者经EBUS-TBNA活检88组淋巴结,其中纵隔淋巴结60组(68.18％),肺门及叶间淋巴结28组(31.82％).38例患者中经EBUS-TBNA明确诊断34例(89.47％).检查耐受良好,无任何相关并发症发生.结论 EBUS-TBNA是一种安全有效的诊断方法,对于胸部淋巴结结核有较高的诊断率.%Objective To evaluated the role of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of thoracic tuberculosis.Methods The study was retrospective,from September 2009 to September 2012,38 patients who underwent EBUS-TBNA were finally diagnosed of thoracic tuberculosis,with enlarged hilar or mediastinal Iymph nodes on chest enhanced computed tomography(≥ 1.0 cm).Patients in whom EBUS TBNA was nondiagnostic subsequently underwent surgical biopsy.All the patients had a minimum of 6 months clinical and radiologic follow-up.Results EBUS-TBNA was performed on a total of 88 lymph node stations in 38 patients.Of the enlarged lymph nodes,60(68.18％) were located in the mediastinal region and the remaining 28 (31.82 ％) around the hilum or interlobar area.Of the 38 patients,EBUS-TBNA achieved definitive diagnosis in 34 patients(89.47％).EBUS was well tolerated by all of the patients with no complications.Conclusion EBUS-TBNA is a safe procedure with a high yield for the diagnoses of thoracic tuberculosis.