经支气管针吸活检术在现代儿科介入呼吸病学的应用
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摘要
经支气管针吸活检术(transbronchial needle aspiration,TBNA)是一项重要的呼吸内镜介入诊疗技术,它在纵隔、肺门、肺部外周结节病变的性质诊断,以及肺癌的分型分期等方面发挥了非常重要的作用。相较于纵隔镜及开胸探查术,TBNA具有操作简便、创伤小、费用低及并发症少等特点,在成人呼吸系统疾病得到广泛应用。但儿童因自身特点,对TBNA的技术、器材、麻醉等要求较高,应用TBNA时面临更多的挑战。随着技术的不断改进,以及儿童呼吸介入医师的不断探索,TBNA在儿童中运用也越来越多,填补了常规诊治过程中的空白,为纵隔或肺门病变患儿带来新的诊断理念和方法。
()portant technique of endoscopic interventional diagnosis and treatment of lung disease. It plays an important role in the diagnosis of the nature of mediastinal, hilar and peripheral nodule lesions,as well as in the classification and staging of lung cancer. Compared with mediastinoscopy and thoracotomy,TBNA has the advantages of simple operation,less trauma,low cost and fewer complications. It has been widely used in adult respiratory diseases. However,because of their own characteristics,children have higher requirements on TBNA technology,equipment,anesthesia and so on,and the application of TBNA faces more challenges. With the continuous improvement of technology and the continuous exploration of pediatric respiratory interventional physicians,TBNA has been used more and more often in children,filling in the blank of routine diagnosis and treatment and bringing new diagnostic ideas and methods for children with mediastinal or hilar lesions.
()portant technique of endoscopic interventional diagnosis and treatment of lung disease. It plays an important role in the diagnosis of the nature of mediastinal, hilar and peripheral nodule lesions,as well as in the classification and staging of lung cancer. Compared with mediastinoscopy and thoracotomy,TBNA has the advantages of simple operation,less trauma,low cost and fewer complications. It has been widely used in adult respiratory diseases. However,because of their own characteristics,children have higher requirements on TBNA technology,equipment,anesthesia and so on,and the application of TBNA faces more challenges. With the continuous improvement of technology and the continuous exploration of pediatric respiratory interventional physicians,TBNA has been used more and more often in children,filling in the blank of routine diagnosis and treatment and bringing new diagnostic ideas and methods for children with mediastinal or hilar lesions.
引文
[1] Xia Y,Wang KP. Transbronchial needle aspiration:Where are we now[J]. J Thorac Dis,2013,5(5):678-682.
[2]荣福.经支气管针吸活检需要超声引导吗?[J].中华结核和呼吸杂志,2013,36(1):8-10.
[3] Schieppati E. Mediastinal puncture thru the tracheal carina[J].Rev Asoc Med Argent,1949,63(6):497-499.
[4] Wang KP,Terry P,Marsh B. Bronehoseopie needle aspiration biopsy of paratracheal tumors[J]. Am Rev Respir Dis,1978,118(1):17-21.
[5]马芸,杨会,珍张苑,王国本.经支气管针吸活检术的过去、现在和未来.中华结核和呼吸杂志,2014,37(11):862-864.
[6]叶乐平,刘玺诚,Wang KP.经支气管针吸活检术在儿科中的临床应用现状及展望[J].中华儿科杂志,2014,52(10):767-769.
[7] Wang KP. The staging of lung cancer by bronchoscopic transbronchial needle aspiration[J]. Chest Surg Clin N Am,1996,6(3):223-235.
[8] Gilbert CR,Chen A,Akulian JA,et al. The use of convex probe endobronehial ultrasound--guided transbronchial needle aspiration in a pediatric population:A multicenter study[J]. Pediatr Pulmonol,2014,49(6):807-815.
[9] Wurzel DF,Steinfort DP,Massie J,et al. Paralysis and 8 perihilar pmtn--beranee:an unusual presentation of sarcoidosis in a child[J]. Pediatr Pulmonol,2009,44(4):410-414.
[10]叶乐平,陈成水,叶民,等.儿童纵隔及肺门淋巴结经支气管针吸活检术国内首例报道[J].中华儿科杂志,2014,52(2):146-148.
[11]国家卫生健康委员会人才交流服务中心儿科呼吸内镜诊疗技术专家组.中国儿科可弯曲支气管镜术指南(2018年版)[J].中华实用儿科临床杂志,2018,33(13):983-989.
[12] Gross A,Diacon AH. Cardiac tamponade following transbronchial needle aspiration[J]. Respiration,2011,82(1):56-59.
[2]荣福.经支气管针吸活检需要超声引导吗?[J].中华结核和呼吸杂志,2013,36(1):8-10.
[3] Schieppati E. Mediastinal puncture thru the tracheal carina[J].Rev Asoc Med Argent,1949,63(6):497-499.
[4] Wang KP,Terry P,Marsh B. Bronehoseopie needle aspiration biopsy of paratracheal tumors[J]. Am Rev Respir Dis,1978,118(1):17-21.
[5]马芸,杨会,珍张苑,王国本.经支气管针吸活检术的过去、现在和未来.中华结核和呼吸杂志,2014,37(11):862-864.
[6]叶乐平,刘玺诚,Wang KP.经支气管针吸活检术在儿科中的临床应用现状及展望[J].中华儿科杂志,2014,52(10):767-769.
[7] Wang KP. The staging of lung cancer by bronchoscopic transbronchial needle aspiration[J]. Chest Surg Clin N Am,1996,6(3):223-235.
[8] Gilbert CR,Chen A,Akulian JA,et al. The use of convex probe endobronehial ultrasound--guided transbronchial needle aspiration in a pediatric population:A multicenter study[J]. Pediatr Pulmonol,2014,49(6):807-815.
[9] Wurzel DF,Steinfort DP,Massie J,et al. Paralysis and 8 perihilar pmtn--beranee:an unusual presentation of sarcoidosis in a child[J]. Pediatr Pulmonol,2009,44(4):410-414.
[10]叶乐平,陈成水,叶民,等.儿童纵隔及肺门淋巴结经支气管针吸活检术国内首例报道[J].中华儿科杂志,2014,52(2):146-148.
[11]国家卫生健康委员会人才交流服务中心儿科呼吸内镜诊疗技术专家组.中国儿科可弯曲支气管镜术指南(2018年版)[J].中华实用儿科临床杂志,2018,33(13):983-989.
[12] Gross A,Diacon AH. Cardiac tamponade following transbronchial needle aspiration[J]. Respiration,2011,82(1):56-59.