| Objective To evaluate the application value of radial ultrasound sheath guided frozen lung biopsy in peripheral lung diseases.Methods Collect the patients with peripheral lung diseases that negative results from routine bronchoscopy admitted in our hospital from March 01,2019 to December31,2019 were randomly divided into two groups:endobronchial ultrasound with a guide sheath combined with transbronchial cryobiopsy group(EBUS-GS-TBCB group)and endobronchial ultrasound with a guide sheath combined with transbronchial lung biopsy(EBUS-GS-TBLB group).The general data of the patients were collected,including age,sex,underlying diseases,symptoms,blood routine,coagulation,tumor markers of lung cancer,electrocardiography,echocardiography,chest CT,etc.,as well as biopsy site,number of biopsies,tissue size obtained from biopsy,time of biopsy of bronchoscope,pathological results of lung tissue,complications,etc.Accuracy of pathological diagnosis of lung tissue based on follow-up results,to compare the diagnostic positive rate,operation failure rate,specimen size,and complications such as airway bleeding,pneumothorax and airway tear in the EBUS-GS-TBCB group and the EBUS-GS-TBLB group.Results1.A total of 43 patients who met the selection criteria were collected,including 29males and 14 females,mean age was(63.07±9.427)years old.The EBUS-GS-TBCB group consisted of 17 cases,of including 13 males and 4 female,mean age was(63.88±8.746)years old.There were 26 cases in the EBUS-GS-TBLB group,including16 males and 10 females,mean age was(62.54±9.981)years old.There was no significant difference between the two groups(t=0.119,P=0.732).2.There were 17 successful cases of biopsy in the EBUS-GS-TBCB group,all the samples were satisfactory,and there was no failure of biopsy.15.4%(4/26)of the 26selected patients in the EBUS-GS-TBLB group did not obtain pathological tissue due to the failure of biopsy,and the samples of 22 successful cases were satisfactory.The operation failure rate was 0%(0/17)in EBUS-GS-TBCB group and 15.4%(4/26)in EBUS-GS-TBLB group,there was no significant difference between the two groups(X~2=2.884,P=0.140).3.The diagnostic positive rates of the EBUS-GS-TBCB group and the EBUS-GS-TBLB group were 94.1%(16/17)and 90.9%(20/22),the difference between the two groups was not statistically significant(X~2=4.914,P=0.314).The sensitivity of the EBUS-GS-TBCB group and the EBUS-GS-TBLB group was 66.7%(8/12)and75.0%(9/12),the difference between the two groups was not statistically significant(X~2=0.202,P=1.000).The specificity of the EBUS-GS-TBCB group and the EBUS-GS-TBLB group was 100%(5/5)and 100%(10/10),there was no statistically significant difference between the two groups(X~2=0.234,P=1.000).The accuracy of the two groups was 76.4%(13/17)and 86.7%(19/22),and there was no significant difference between the two groups(X~2=0.699,P=0.727).4.Comparing the tissue size obtained from the two groups,the average tissue size of EBUS-GS-TBCB group was(22.8±14.8)mm~2,and that of EBUS-GS-TBLB group was(2.4±11.4)mm~2,the difference between the two groups was statistically significant(t=5.664,P=0.000).There was no significant correlation between freezing time and frozen tissue specimen area(X~2=67.163,P=1.000).5.The incidence of complications was 88.3%(15/17)in the EBUS-GS-TBCB group,of which the incidence of bleeding was 76.5%(13/17)and the incidence of pneumothorax was 11.8%(2/17);In the EBUS-GS-TBCB group,the incidence of complications was36.3%(8/22),the incidence of bleeding was 36.3%(8/22),and the incidence of pneumothorax was 0%(0/22).The difference in the incidence of bleeding between the two groups was statistically significant(X~2=7.650,P=0.010).There was no significant difference in the incidence of pneumothorax between the two groups(X~2=2.728,P=0.184).No bleeding or other serious complications occurred during biopsy in both groups.6.The average time of a single biopsy in the EBUS-GS-TBCB group and the EBUS-GS-TBLB group was(3.15±0.76)minutes and(1.27±0.40)minutes,respectively.The difference between the two groups was statistically significant(t=9.208,P=0.000).The average operating time of individual cases in the cryobiopsy group and the biopsy forceps group was(5.88±3.44)minutes and(10.45±3.66)minutes.The difference between the two groups was statistically significant(t=-4.000,P=0.000).Conclusion There was no significant difference between EBUS-GS-TBCB and EBUS-GS-TBLB,but EBUS-GS-TBCB has obvious advantages in the number of acquired lesion tissues and in reducing the operative time of patients.the value of EBUS-GS-TBCB in peripheral lung disease needs further observation. |
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