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目的通过回顾具有完整影像学检查资料的肺孤立性结节或肿块病变患者支气管镜检查的镜下表现,了解病灶位置和大小与支气管镜下有无可见异常之间的可能联系。方法回顾分析了96例有完整肺部CT和镜下表现记录的病历资料,按病变大小(最大直径分1cm以下,大于1cm不大于2cm,大于2cm不大于3cm,3cm以上,共四种情况)和肺野分布位置(侵及近肺门区、侵及中间区未侵及近肺门区、仅侵及外周区,共三种情况)作为分类基础,以镜下有粘膜异常和或结构异常、无可见异常两种情况为观察指标统计分析。结果2cm以下的病灶镜下可见粘膜和结构改变比例较少,与大于2cm的病变组间有显著差异(p<0.05);仅侵及外周区病灶镜下可见粘膜和结构改变比例少,与侵及近肺门区、侵及中间区组间有显著差异(p<0.05)。结论对影像学表现为2cm以下和或侵及外周区的肺孤立性结节或肿块病变,支气管镜检查宜直接在血管X光机的介入室进行,可提高肺活检的阳性率。
Objective To investigate the possible relationship between the location and size of lesions and the presence or absence of visible abnormalities in bronchoscopy by reviewing the microscopic findings of bronchoscopy in patients with solitary pulmonary nodules or mass lesions with complete radiological findings. Methods A total of 96 cases with complete lung CT and microscopic records were retrospectively analyzed. According to the size of the lesion (maximum diameter less than 1cm, more than 1cm no more than 2cm, more than 2cm no more than 3cm, more than 3cm) And the distribution of lung field location (invasion and near the hilar area, the invasion of the middle area and near the hilar area, only the invasion and the peripheral area, a total of three cases) as the basis for the classification of microscopic mucosal abnormalities and or structural abnormalities , No abnormalities were observed in two cases of statistical analysis. Results The lesion size less than 2cm showed a small proportion of mucosal and structural changes, with a significant difference (p <0.05) between lesion groups larger than 2cm and only a small proportion of mucosal and structural changes, And near the hilar area, invasion and the middle of the group were significantly different (p <0.05). Conclusions For pulmonary solitary nodules or mass lesions of less than 2 cm in diameter and invaded the peripheral region, bronchoscopy should be performed directly in the interventional room of a vascular X-ray machine to improve the positive rate of lung biopsy.