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末支支支气管超声波引导的跨支气管节点活检和跨支气管针吸收之间的比较:一个元分析

Wuchen Yang^1,2, Huizhen Yang³, Quncheng Zhang²

¹Department of Anesthesiology, Fuwai Central China Cardiovascular Hospital, Zhengzhou, China.

Respiration; international review of thoracic diseases

|August 13, 2024

概括

使用子或冷探针进行的横支气管结节活检 (TBNB) 与内支气管超声波引导的横支气管针吸收 (EBUS-TBNA) 相比,为胸内淋巴腺症提供了更好的诊断产量. 虽然TBNB的并发症率高于EBUS-TBNA,但它仍然比手术活检更安全.

科学领域:

肺部病理学肺部病理学
干预性肺病学干预性肺病学
诊断成像诊断成像诊断成像

背景情况:

经 bronchial needle aspiration (EBUS-TBNA) 的结果往往是组织样本不足,特别是对于淋巴瘤,肉类发病和淋巴结核结核病等疾病.
使用子或冷探针进行的跨支气管结节活检 (TBNB) 是一种新的技术,旨在提高样本质量和诊断准确性.

研究的目的:

系统地审查和比较EBUS-TBNB与EBUS-TBNA的安全性和灵敏性,用于诊断胸内淋巴结核病和质病变.
评估EBUS-TBNB和EBUS-TBNA的诊断产量和并发症率.

主要方法:

在主要数据库 (MEDLINE,Embase,Cochrane,CNKI) 进行了系统的文献搜索.
通过QUADAS-2工具评估研究质量.
使用反变量加权进行了元分析,以估计诊断产量并比较这两种技术.

主要成果:

综合诊断收益率为EBUS-TBNA的77.80%和EBUS-TBNB的86.01% (OR,3.13;p=0.0008). 这两种组合的诊断收益率是相同的.
与EBUS-TBNA相比,EBUS-TBNB在恶性瘤 (90.84%与84.53%) 和良性瘤 (86.62%与71.19%) 的诊断产量更高.
整体并发症很低,包括出血 (0.90%) 和肺胸部 (0.49%),EBUS-TBNB的发病率高于EBUS-TBNA.

结论:

与EBUS-TBNA相比,EBUS-TBNB显著提高了胸内淋巴结核病和质病变的诊断产量.
虽然EBUS-TBNB的并发症率高于EBUS-TBNA,但它被认为比手术活检选择更安全.

关键词:

末支支支气管超声波检查结果淋巴腺病变 (Lymphadenopathy) 是一种淋巴腺病变.节点活组织检查通过支气管的针吸收.

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