Value Of Endobronchial Ultrasound Guided Transbronchoscopic Lung Biopsy Without Guide Sheath In The Diagnosis Of Peripheral Pulmonary Lesions

Objective:The purpose of the research is explored the diagnostic value of radial endobronchial ultrasound for peripheral pulmonary lesions and analysis the influencing factors.To discuss the value of endobronchial ultrasound guided transbronchoscopic lung biopsy without guide sheath in the real world.Methods:This study is a retrospective study,Collect and collate the clinical data of patients in the Zhong Da hospital affiliated to southeast university from January 2017 to December 2017.All the patients take chest CT and found peripheral pulmonary lesions.334 patients do conventional transbronchoscopic lung biopsy.436 patients do endobronchial ultrasound guided transbronchoscopic lung biopsy without guide sheath.The general data,location,size,frequency,complications,final diagnosis and ultrasound images of the patients were collected.Summarize and analyze the positive rate of diagnosis and the related factors.Results:1.Finally,549 patients got a clear diagnosis.The diagnosis rate of transbronchoscopic lung biopsy was 42.48%(96 / 226).The diagnosis rate of endobronchial ultrasound guided transbronchoscopic lung biopsy was 73.68%(238 / 323).There was a significant difference between the two groups(P < 0.05).2.There was no significant difference in diagnosis rate between the benign lesions group and the malignant lesions group(P < 0.05).When the lesion diameter ≥ 2cm,the diagnosis rate is higher than the lesion diameter < 2cm(P < 0.05).When the lesions were located in in the right upper lobe,the diagnosis rate was lower than the lesions in other lobe(P < 0.05).When the ultrasound probes in the lesions,the diagnosis rate was higher.(P < 0.05).When the number of biopsies more than 4,the diagnosis rate was higher(P<0.05).3.The complications of endobronchial ultrasound guided transbronchoscopic lung biopsy were hemoptysis,chest pain and pneumothorax.The minor hemorrhage bleeding during and after operation is common.Most of them don’t need to special treatment.The excessive bleeding is rare.Conclusion:Compare with the conventional transbronchoscopic lung biopsy,the endobronchial ultrasound guided transbronchoscopic lung biopsy had a higher diagnostic rate for peripheral pulmonary lesions.The size of the lesions,the location of the lesions,the relative location of lesions and probe,and the number of biopsies were the related factors affecting the diagnostic rate.When the longest diameter of the lesion is ≥ 2cm,the lesion is located in the upper right lobe,the ultrasonic probe is located in the lesion,and the number of biopsies is more than 4,the diagnostic rate of biopsies will be improved.Transbronchoscopic lung biopsy guided by radial ultrasound without guiding sheath is a relatively safe diagnostic technique.