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支气管腔内超声技术的临床应用及进展
王健男,黄海东*,白冲
0
(海军军医大学(第二军医大学)长海医院呼吸与危重症医学科, 上海 200433
*通信作者)
摘要:
随着胸部CT筛查的普及,肺外周、纵隔病灶的检出率大大提高。为了提高传统支气管镜的诊断率,新的技术不断出现。支气管腔内超声(EBUS)是一种同时结合了支气管镜和超声的微创诊疗技术,可以提供气道壁和支气管树邻近结构的超声图像及实时引导活检,类型主要包括凸探头式支气管腔内超声(CP-EBUS)和径向微探头导管支气管腔内超声(RP-EBUS)。CP-EBUS主要应用于大气道及肺中央型病变,在肺癌纵隔分期中发挥重要的作用,RP-EBUS综合导引技术主要用于诊断肺周围型病变,此外EBUS也可用于一些肺外毗邻脏器疾病的微创诊断和治疗。EBUS具有风险低、诊断良恶性病灶灵敏性高、重复性好等优势,已在全世界范围内广泛应用于临床并不断发展。本文就EBUS的发展史和临床应用及进展进行综述。
关键词:  超声支气管镜  肺肿瘤  微创诊断  经支气管针吸活检  肺周围型病变
DOI:10.16781/j.0258-879x.2021.09.1044
投稿时间:2021-01-08修订日期:2021-06-08
基金项目:
Clinical application and progress of endobronchial ultrasound
WANG Jian-nan,HUANG Hai-dong*,BAI Chong
(Department of Respiratory and Critical Care Medicine, Changhai Hospital, Naval Medical University (Second Military Medical University), Shanghai 200433, China
*Corresponding author)
Abstract:
With the popularization of chest computed tomography (CT) screening, the detection rates of pulmonary peripheral lesions and mediastinal masses have been greatly increased. Novel technologies are emerging to improve the diagnostic rate of traditional bronchoscopy. Endobronchial ultrasound (EBUS) is a minimally invasive diagnosis and treatment technology combining bronchoscopy and ultrasound. It can provide ultrasound images and guide biopsy of airway wall and adjacent structures of bronchial tree in real time. The main types include convex probe-endobronchial ultrasound (CP-EBUS) and radial probe-endobronchial ultrasound (RP-EBUS). CP-EBUS is mainly used in the major airway and central lung lesions, and plays an important role in mediastinal staging of lung cancer. RP-EBUS comprehensive guidance technology is mainly used in the diagnosis of peripheral lung lesions. In addition, EBUS can also be applied to the minimally invasive diagnosis and treatment of some extrapulmonary adjacent organ diseases. With the advantages of low risk, high sensitivity to benign and malignant lesions and good repeatability, EBUS has been widely used in clinical practice all over the world. This paper reviews the development history, clinical application and progress of EBUS.
Key words:  endobronchial ultrasound  lung neoplasms  minimally invasive diagnosis  transbronchial needle aspiration biopsy  peripheral pulmonary lesions