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首页> 外文期刊>Journal of bronchology & interventional pulmonology >New technique for endobronchial ultrasound-guided transbronchial needle aspiration to improve diagnostic yield.
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New technique for endobronchial ultrasound-guided transbronchial needle aspiration to improve diagnostic yield.

机译：支气管内超声引导经支气管针抽吸的新技术，可提高诊断率。

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摘要

Although the pooled sensitivity of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) using a convex scanning ultrasound bronchoscope is equivalent to the gold standard of mediastinoscopy, diagnosis cannot be obtained in a small number of patients with poor cellularity. The method described was investigated with the aim of avoiding puncturing the cartilage and enabling reliable tissue harvesting, as this can be expected to improve diagnostic yield.Outer sheath method (OSM): While pressing the outer sheath (OS) of the puncture needle gently against the bronchial wall, the hyperechoic line appeared on surface of the bronchial wall on EBUS image. Then pulling and pushing the entire bronchoscope, the tip of OS moved to the epithelium above the bronchial cartilage while detecting the best position for puncturing on the EBUS images simultaneously. The bronchoscopist could visualize the cartilage moving longitudinally on EBUS image. The movement of the cartilage was stopped when the tip of the OS was caught in a concavity between 2 rings of cartilage. Group A consisted of 169 patients who underwent EBUS-TBNA before the introduction of OSM, and group B consisted of 169 patients who underwent EBUS-TBNA after the introduction of OSM. These 2 groups were compared with to investigate the usefulness of OSM.Adding this operation enabled a suitable puncture site to be identified, significantly improving diagnostic yield from 92.7% (group A) to 98.2% (group B).This method was regarded as useful for improving diagnostic yield by enabling the selection of a puncture site between rings of cartilage during EBUS-TBNA.
机译：尽管使用凸面扫描超声支气管镜进行的支气管内超声引导的经支气管针抽吸术（EBUS-TBNA）的合并敏感性等同于纵隔镜检查的金标准，但在少数细胞性差的患者中无法获得诊断。研究所述方法的目的是避免刺破软骨并实现可靠的组织收集，因为这有望提高诊断率。外鞘法（OSM）：在将穿刺针的外鞘（OS）轻轻按向的同时在EBUS图像上，高回声线出现在支气管壁上。然后拉动并推动整个支气管镜，将OS的尖端移至支气管软骨上方的上皮，同时检测在EBUS图像上同时穿刺的最佳位置。支气管医师可以在EBUS图像上可视化纵向移动的软骨。当OS的尖端卡在两个软骨环之间的凹处时，软骨的运动就停止了。 A组由169例在OSM引入前接受EBUS-TBNA的患者组成，B组由169例在OSM引入后接受EBUS-TBNA的患者组成。将这两组进行比较，以研究OSM的有效性。添加此操作可以确定合适的穿刺部位，从而将诊断率从92.7％（A组）提高到98.2％（B组）。通过在EBUS-TBNA期间选择软骨环之间的穿刺部位来提高诊断率。

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