径向超声、虚拟导航、超细支气管镜联合评价对肺外周结节的诊断价值

摘要

目的 探讨径向超声(EBUS)联合虚拟导航(VBN)对肺外周结节的诊断价值.方法 纳入2014年7月至2015年7月就诊唐都医院呼吸科的肺外周结节病变患者240例(0.8 cm＜直径＜3 cm),根据引导设备不同,分为径向超声联合虚拟导航组(EBUS+VBN组)、径向超声组(EBUS组)、虚拟导航组(VBN组)和对照组,分别行4组间诊断率的比较及病变不同大小时诊断率的比较,EBUS+ VBN组与EBUS组定位病变时间及操作时间的比较.结果 240例患者中,EBUS+ VBN组诊断率最高(81.67％),4组间诊断率差异有统计学意义(x2=19.34,P=0.00);EBUS+ VBN组、EBUS组在直径小于或等于2 cm的病灶中诊断率低于直径大于2 cm的病灶,但差异无统计学意义(x2=2.04、3.40,P=0.15、0.07);EBUS+ VBN组较EBUS组定位病变时间及操作时间均短,且差异无统计学意义(P=0.03、0.04).结论 径向超声联合虚拟导航可提高肺外周结节的诊断率,缩短定位病变时间及操作时间.%Objective To explore the diagnostic value of radial ultrasound (EBUS) combined with virtual navigation (VBN) in peripheral pulmonary nodules.Methods Two hundreds and forty cases of peripheral pulmonary nodules(0.8 cm≤diameter≤3 cm) in the respiratory department of our hospital from July 2014 to July 2015 were included and according to the different guide de vices,which were divided into the radial ultrasound combined with virtual navigation group (EBUS+ VBN group),radial ultrasound group (EBUS group),virtual navigation group (VBN group) and control group.The diagnostic rates were compared among the four groups and among different sizes of lesion.The time of lesion location and operating time were also compared between the EBUS+ VBN group and EBUS group.Results Among 240 cases,the diagnostic rate in the EBUS+VBN group was highest(81.67％),and the diagnostic rates had statistically significant difference among the four groups (x2=19.344,P=0.00);the diagnostic rates of lesions less than 2 cm in diameter were lower than that of lesions ＞2 cm in the EBUS+-VBN group and EBUS group,but without statistically significant difference (x2 =2.04,3.40,P =0.15,0.07);the locating lesions time and operating times in the EBUS+ VBN group were shorter than those in the EBUS group,but the difference between them was not statistically significant (P=0.03,0.04).Conclusion EBUS combined with VBN could improve the diagnostic rate of peripheral pulmonary nodules and shorten the time of lesion location and operating time.