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[目的]探讨经纤维支气管镜针吸活检术(TBNA)对肺门、纵隔肿物的诊断价值。[方法]对38例胸部CT检查发现纵隔、肺门软组织肿块阴影,临床诊断性质待定,常规纤维支气管镜检查无支气管腔内肿块或仅有外压性改变的患者,经纤维支气管镜穿刺针吸活检术,直接涂片送检。同时抽取胸部CT表现相同的同期肿瘤仅行常规纤维支气管镜检查的38例患者设为对照组。[结果]TBNA组诊断阳性率为86.8%,主要并发症为穿刺点少量出血,未出现纵隔气肿、感染等严重不良反应;对照组诊断阳性率为28.9%(χ2=26.125,P=0.000)。[结论]TB-NA诊断阳性率高,创伤小,特异性强,安全性高,对诊断纵隔及肺门病变性质,明确肿瘤分期有很高的临床价值。
[Objective] To investigate the value of transbronchial needle aspiration biopsy (TBNA) in the diagnosis of hilar and mediastinal masses. [Methods] Thirty-eight cases of mediastinum and hilar soft tissue mass were found by CT scan in thorax. The clinical diagnostic properties were determined. The patients without endobronchial mass or only external pressure were examined by conventional bronchofibroscopy. Biopsy, direct smear submission. Thirty-eight patients who underwent concurrent CT scan with the same thoracic CT scan at the same time underwent routine bronchofibroscopy as the control group. [Results] The positive rate of diagnosis in TBNA group was 86.8%. The main complication was minor bleeding at puncture site, no serious adverse reactions such as emphysema and infection of mediastinum. The positive rate of diagnosis in control group was 28.9% (χ2 = 26.125, P = 0.000) . [Conclusion] The positive rate of TB-NA diagnosis is high, the trauma is small, the specificity is strong and the safety is high. It has high clinical value in diagnosing the nature of mediastinum and hilar lesions and staging the tumor.