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中华诊断学电子杂志 ›› 2016, Vol. 04 ›› Issue (03) : 203 -205. doi: 10.3877/cma.j.issn.2095-655X.2016.03.014

所属专题: 文献

临床研究

电磁导航支气管镜在肺外周结节诊断中的意义
吴宝妹1, 李玉梅1,(), 侯黎莉1, 吴颖1, 顾晔1   
  1. 1. 200433 同济大学附属上海市肺科医院内镜科
  • 收稿日期:2016-06-13 出版日期:2016-08-26
  • 通信作者: 李玉梅
  • 基金资助:
    申康新兴联合公关前沿技术基金资助项目(SHDC12012111)

The Diagnostic value of electromagnetic navigation bronchoscopy for pulmonary peripheral nodules

Baomei Wu1, Yumei Li1,(), Lili Hou1, Ying Wu1, Ye Gu1   

  1. 1. Department of Endoscopy, Shanghai Pulmonary Hospital Affiliated to Tongji University, Shanghai 200433, China
  • Received:2016-06-13 Published:2016-08-26
  • Corresponding author: Yumei Li
  • About author:
    Corresponding author: Li Yumei, Email:
引用本文:

吴宝妹, 李玉梅, 侯黎莉, 吴颖, 顾晔. 电磁导航支气管镜在肺外周结节诊断中的意义[J]. 中华诊断学电子杂志, 2016, 04(03): 203-205.

Baomei Wu, Yumei Li, Lili Hou, Ying Wu, Ye Gu. The Diagnostic value of electromagnetic navigation bronchoscopy for pulmonary peripheral nodules[J]. Chinese Journal of Diagnostics(Electronic Edition), 2016, 04(03): 203-205.

目的

探讨电磁导航支气管镜(ENB)对肺外周结节的诊断意义。

方法

选择2014年6月至2016年5月于上海市肺科医院住院患者83例,进行ENB检查,术中导航成功后结合外周超声确认位置,并在X线透视下进行标本获取,送病理学检测。根据检查结果来确定ENB对肺外周结节的诊断价值。

结果

共有83例患者接受ENB检查,合计87处病灶,阳性诊断率为86.00%。导航时间为(23.06±15.68)min,曝光时间为(1.89±1.53)min,手术时间为(75.27±37.08)min;无并发症发生。较既往文献报道的单纯外周超声系统曝光时间(4.08±3.27)min缩短,差异有统计学意义(t=7.32,P<0.05)。

结论

熟练使用导航联合外用超声技术是避免操作并发症的关键步骤。利用ENB技术诊断肺外周小结节具有较高的阳性率,值得进行临床推广。

Objective

To explore the diagnostic value of electromagnetic navigation bronchoscopy (ENB) for pulmonary peripheral nodules.

Methods

Eight-three patients from June 2014 to Mar 2016 in Shanghai Pulmonary Hospital were enrolled.The ENB was performed on those patients who were detected peripheral lung nodules by chest CT.After being successfully navigated, the lesion location was confirmed by peripheral ultrasound and specimens were acquired under X-ray assistant.The specimens were finally sent to determine the pathologic classification and the value of ENB was determined according to the pathologic examination results.

Results

A total of 83 patients were enrolled in this study and the lesions were 87, the positive predictive was 86.00%.The mean navigation time was (23.06±15.68)min, exposure time was (1.89±1.53)min, operation time was (75.27±37.08)min, and no procedure-related complications were observed.The exposure time was significantly shorten than that in patients who were confirmed the location of peripheral lung nodules by peripheral ultrasound merely (t=7.32, P<0.05).

Conclusion

Skilled operation is the successful key to avoid complications.The positive rate of ENB in the diagnosis of pulmonary peripheral nodules is high and ENB is worth promoting.

[1]
Gould MK,Ananth L,Barnett PG, et al.A clinical model to estimate the pretest probability of lung cancer in patients with solitary pulmonary nodules[J]. Chest, 2007, 131(2): 383-388.
[2]
Rivera MP,Mehta AC.American college of chest physicians.Initial diagnosis of lung cancer:ACCP evidence-based clinical practice guidelines (2nd edition)[J]. Chest, 2007, 132(3 Suppl): 131S-148S.
[3]
Gould MK,Fletcher J,Iannettoni MD, et al.Evaluation of patients with pulmonary nodules:when is it lung cancer:ACCP evidence-based clinical practice guidelines (2 nd edition)[J]. Chest, 2007, 132(3 Suppl): 108S-130S.
[4]
Paone G,Nicastri E,Lucantoni G, et al.Endobronchial ultrasound-driven biopsy in the diagnosis of peripheral lung lesions[J]. Chest, 2005, 128(5): 3551-3557.
[5]
Fujita Y,Seki N,Kurimoto N, et al.Introduction of endobronchial ultrasonography (EBUS) in bronchoscopy clearly reduces fluoroscopy time:comparison of 147 cases in groups before and after EBUS introduction[J]. Jpn J Clin Oncol, 2011, 41(10): 1177-1181.
[6]
Yasufuku K,Chiyo M,Koh E, et al. Endobronchial ultrasound guided transbronchial needle aspiration for staging of lung cancer[J]. Lung Cancer, 2005, 50(3): 347-354.
[7]
Leong S,Ju H,Marshall H, et al.Electromagnetic navigation bronchoscopy:A descriptive analysis[J]. J Thorac Dis, 2012, 4(2): 173-185.
[8]
Krimsky W,Seijo LM.Bronchoscopy and the peripheral nodule in the age of lung cancer screening and targeted therapies.Curr Respir Care Rep, 2012, 1(1): 67-71.
[9]
Chee A,Stather DR,Maceachern P, et al. Diagnostic utility of peripheral endobronchial ultrasound with electromagnetic navigation bronchoscopy in peripherallung nodules[J]. Respirology, 2013, 18(5): 784-789.
[10]
Edel E,Krier-Morrow D. Navigational bronchoscopy:overview of technology and practical considerations-new current procedural terminology codes effective 2010[J]. Chest, 2010, 137(2): 450-454.
[11]
Quinn CC. Diagnostic approach to pulmonary nodules in the post pneumonectomy patient[J]. Semin Thorac Cardiovasc Surg, 2010, 22(4): 345-348.
[12]
Mahajan AK,Patel S,Hogarth DK, et al.Electromagnetic naviga tional bronchoscopy an effective and safe approach to diagnose peripheral lung lesions unreachable by conventional bronchoscopy in high-risk patients[J]. J Bronchology Interv Pulmonol, 2011, 18(2): 133-137.
[13]
Bechara R,Parks C,Ernst A. Electromagnetic navigation bronchoscopy[J]. Future Oncol, 2011, 7(1): 31-36.
[14]
Eberhardt R,Anantham D,Herth F, et al.Electromagnetic navigation diagnostic bronchoscopy in peripheral lung lesions[J]. Chest, 2007, 131(6): 1800-1805.
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