經電子纖維支氣管鏡活檢術對老年患者呼吸系統腫塊診斷結果分析

藍金鈺　王穎　吳政華

【摘要】 目的：通過分析76例老年患者呼吸系統腫塊經電子纖維支氣管鏡活檢（支氣管鏡下透支氣管壁穿刺活檢）的病理結果，探討并評價經電子纖維支氣管鏡活檢對老年患者呼吸系統腫塊的診斷價值。方法：選取2016年9月-2017年1月筆者所在醫院76例經胸部CT檢查掃描出呼吸系統軟組織類腫塊陰影，其具體性質未確定，行常規的纖維支氣管鏡檢查未發現明顯的外界壓力性改變或支氣管腔內腫塊的老年患者作為研究組，再經電子纖維支氣管鏡活檢術后，將組織涂片直接病理科送檢；隨機抽取經胸部CT檢查后影像學表現相似的同期腫瘤且單純行常規纖維支氣管鏡檢查的74例老年患者設置為對照組。結果：研究組患者的陽性確診率為89.47%，其最主要的合并癥狀是在支氣管鏡的穿刺點伴有少量出血，未發現明顯的感染、呼吸系統氣腫等嚴重并發癥；對照組的陽性確診率為28.37%，兩組陽性確診率比較差異有統計學意義（字2=23.685，P=0.002）。結論：經電子纖維支氣管鏡活檢術是診斷老年患者呼吸系統腫物的有效手段，具有較高的臨床診斷價值，其具陽性確診率高，安全性好，特異性較強，創傷相對小的優點，值得在臨床中進一步采用推廣，但如何進一步提高其陽性檢出率有待于繼續深入探討。

【關鍵詞】 老年患者呼吸系統腫物； 電子纖維支氣管鏡活檢術； 診斷價值

doi：10.14033/j.cnki.cfmr.2017.29.031 文獻標識碼 B 文章編號 1674-6805（2017）29-0062-03

Diagnosis Analysis of the Electronic Fibre Bronchoscopy Biopsy for Elderly Patients with Respiratory System Tumor/LAN Jin-yu，WANG Ying，WU Zheng-hua.//Chinese and Foreign Medical Research，2017，15（29）：62-64

【Abstract】 Objective：To analyze the 76 cases of elderly patients with respiratory system tumor via electronic fibre bronchoscopy biopsy pathology results，analyze and evaluate the diagnostic value of the electronic fibre bronchoscopy biopsy for elderly patients with respiratory system to assess tumor.Method：From September 2016 to January 2017， 76 cases with respiratory mass lesion in our hospital by chest CT examination showed，clinical diagnosis of properties to be determined，the conventional fiber bronchoscope examination without bronchial lumen lumps or only sex change under external pressure of elderly patients as the experimental group，the electronic fibre bronchoscopy biopsy，direct smear inspection；while extracting the chest CT had the same tumor only conventional fiber bronchoscope examination of 74 cases of elderly patients as the control group.Result：The experimental group diagnosis positive rate was 89.47%，the main complications for the puncture point a small amount of bleeding，not present mediastinal emphysema and infection of the serious adverse reactions.The control group diagnosis positive rate was 28.37%，the diagnosis positive rate in two groups was significant（字2=23.685，P=0.002）.Conclusion：Electronic fibre bronchoscopy biopsy is an effective method for diagnosis of elderly patients with respiratory system neoplasm，has high diagnostic value，its diagnosis positive rate is high，small trauma，specificity is strong，the advantages of high safety，is worth popularizing further used in clinical，but how to further improve the positive detection rate to be discussed.

【Key words】 Elderly patients with lung disease； Electronic fibre bronchoscopy biopsy； The diagnosis valueendprint

First-authors address：Anxiang County Peoples Hospital，Anxiang 415600，China

經電子纖維支氣管鏡活檢（支氣管鏡下透支氣管壁穿刺活檢）是呼吸系統疾病診斷和鑒別診斷的重要手段之一[1]。……