不同肺活检方法对老年患者肺部弥漫性间质性疾病的诊断意义

摘要

目的 探讨纤维支气管镜、CT引导下经皮穿刺以及内科胸腔镜肺活检对老年患者肺部弥漫性间质性疾病的诊断意义.方法 回顾性分析我院2014年5月-2016年7月经纤维支气管镜、CT引导下经皮穿刺以及内科胸腔镜实施肺部活检的患者各34例的临床和病理检查资料,对诊断情况及并发症进行比较.结果 胸腔镜组ILD阳性检出率明显高于纤支镜组和穿刺组(P<0.05),胸腔镜组术后并发症发生率、活检和住院费用均高于纤支镜组和穿刺组,且术后住院时间明显延长(P<0.05),差异均具有统计学意义.纤支镜组和穿刺组在ILD阳性检出率、术后并发症、活检和住院费以及住院时间上并无明显差异(P>0.05).结论 纤维支气管镜和CT引导下经皮穿刺术都具有操作简单、创伤小且治疗费用少的特点,可作为诊断老年患者肺部弥漫性间质性疾病的首选活检方式,而对于需要较大活检组织进行病理诊断的患者则应考虑内科胸腔镜活检术以保证检验的准确性.%Objective To study the diagnosis significance of different lung biopsy Methods for elderly patients with interstitial lung disease.Methods The clinical and pathological examination of elderly patients with fiber bronchoscope CT guided percutaneous puncture and medical thoracoscope lung biopsy from May 2014 to July 2016 were retrospectively analyzed, and each method had 34 cases.The diagnosis and complications were compared.Results The positive detection rate of ILD was obviously higher in the thoracoscope group than in the fiber lens group and the puncture group (P<0.05).The incidence of postoperative complications and the cost of biopsy and hospital stay were both higher in the thoracoscope group than in the fiber lens group and the puncture group, and the postoperative duration of hospital stay in the thoracoscope group increased significantly (P<0.05).There was no significant difference between the fiber lens group and the puncture group in ILD positive detection rate, postoperative complications, biopsy and hospitalization, or duration of hospital stay (P>0.05).Conclusion The fiberoptic bronchoscopy and CT guided percutaneous centesis has the characteristics of simple operation, small trauma, and the treatment costs less, so they are can be used as a preferred biopsy diagnosis for elderly patients with diffuse interstitial lung disease, and for larger biopsy tissue pathological diagnosis of patients, medical thoracoscopy biopsy should be considered in order to assure the accuracy of the test.