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《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:

期数:

2024年02期

页码:

185-188

栏目:

论著

出版日期:

2024-04-20

文章信息/Info

Title:

Analysis of consistency between ultrasound-guided pleural biopsy and medical thoracoscopy pleural biopsy in diagnosis

作者:

张红军¹; 顾 兴¹; 赵延军¹; 柴雅琴¹; 李文洁¹; 师 佩¹; 张海涛²

710100 西安,西安市胸科医院呼吸与危重症科¹
710038 西安,空军军医大学第二附属医院(唐都医院)呼吸与危重症科²

Author(s):

Zhang Hongjun¹;  Gu Xing¹;  Zhao Yanjun¹;  Chai Yaqin¹;  Li Wenjie¹;  Shi Pei¹;  Zhang Haitao².

¹Department of Respiratory and Critical Care Medicine, Xi'an Chest Hospital, Xi'an 710100, China; ²Department of Respiratory and Critical Care Medicine, Tangdu Hospital, Air Force Military Medical University, Xi'an 710038, China

关键词:

胸腔积液;  超声引导下胸膜活检;  内科胸腔镜胸膜活检

Keywords:

Pleural effusion;  Ultrasound guided pleural biopsy;  Medical thoracoscopy pleural biopsy

分类号:

R563

DOI:

10.3877/cma.j.issn.1674-6902.2024.02.003

摘要:

目的 通过回顾性分析超声引导下胸膜活检(ultrasound-guided pleural biopsy, USPB)和内科胸腔镜胸膜活检(medical thoracoscopy pleural biopsy, MTPB)的胸腔积液患者临床资料,分析两种取材方法的选择和诊断一致性。方法 选择2020年10月至 2023年5月由我院呼吸与危重症医学科进行超声引导下胸膜活检和内科胸腔镜胸膜活检的胸腔积液患者74例,对临床资料、胸腔积液特征、取材质量和病理诊断价值进行分析。结果 先行超声引导下胸膜活检后再行内科胸腔镜胸膜活检患者USPB+MTPB组40例,取材的病理诊断价值并不优于直接行内科胸腔镜胸膜活检患者MTPB组34例,差异具有统计学意义(P<0.001)。40例USPB+MTPB组患者中,USPB和MTPB所取标本大小0.004(0.003,0.011)mm³和0.105(0.026,0.230)mm³,差异具有统计学意义(P<0.001)。进一步分析,USPB取材病理诊断价值并不优于MTPB,差异具有统计学意义(P<0.001)。USPB和MTPB的阳性率是65.00%和95.00%; 阴性率分别是35.00%和5.00%。USPB和MTPB的可靠性评价指标卡帕值(Kappa value)=0.038。结论 MTPB在阳性诊断率、取材质量和病理诊断价值方面优于USPB,临床在二者的选择上应结合患者个体化、安全性及可及性等进行综合考虑。

Abstract:

Objective The clinical data of patients with pleural effusion by ultrasound guided pleural biopsy(USPB)and medical thoracoscopic pleural biopsy(MTPB)were retrospectively analyzed, to explore the selection and diagnostic consistency of these two sampling methods. Methods 74 patients with pleural effusion by USPB and MTPB were recruited in the Department of Respiratory and Critical Care Medicine of our hospital from October 2020 to May 2023. The general clinical data, pleural effusion characteristics, sample quality, and pathological diagnostic value were analyzed. Results The pathological diagnostic value of patients who underwent USPB before undergoing MTPB(USPB+MTPB group)40 cases was not superior to those who directly underwent MTPB(MTPB group)34 cases, and the difference was statistically significant(P=0.007). Among the 40 patients in the USPB+MTPB group, the sample sizes of USPB and MTPB were 0.004(0.003,0.011)mm³ and 0.105(0.026,0.230)mm³, with statistically significant differences(P<0.001); the pathological diagnostic value of USPB is not superior to that of MTPB, and the difference is statistically significant(P<0.001). The positive rates of USPB and MTPB were 65.00% and 95.00%, respectively; the negative rates were 35.00% and 5.00%, respectively. The reliability evaluation index Kappa value of USPB and MTPB is 0.038. Conclusion MTPB is superior to USPB in terms of positive diagnostic rate, sample quality, and pathological diagnostic value. Clinicians should also consider patient individualization, safety, and accessibility when selecting the two.

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备注/Memo

备注/Memo:

基金项目: 西安市科技计划项目(2022JH-YBYJ-0157) 通信作者: 师 佩, Email: 476778627@qq.com

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更新日期/Last Update: 2024-04-20