【摘要】 目的：探讨程序化诊断在恶性孤立性肺结节中的诊断价值。方法：选取2018年7月—2020年7月河南科技大学附属许昌市中心医院56例高度疑似恶性孤立性肺结节患者1作为研究对象。依次进行普通支气管镜检查、经支气管镜肺活检、CT定位经皮肺穿刺活检直至确诊，对比程序化诊断及单独诊断恶性孤立性肺结节的价值。结果：156例高度疑似恶性孤立性肺结节患者经手术切除病理诊断或随访确诊恶性103例，经支气管镜肺活检确诊恶性82例，确诊率61.65%。51例未确诊恶性，恶性病灶表现新生物，附坏死物，支气管口狭窄、浸润、增厚、表面凹凸不平，管口闭塞。经CT定位经皮肺穿刺活检确诊恶性43例，确诊率84.31%。仍有8例经程序化诊断未确诊恶性。程序化诊断恶性孤立性肺结节确诊率高于普通支气管镜检查、经支气管镜肺活检、CT定位经皮肺穿刺活检诊断，差异有统计学意义（χ~2=224.271,P<0.05）。程序化诊断，CT定位经皮肺穿刺活检敏感度、准确度高于经支气管镜肺活检、普通支气管镜，差异有统计学意义（χ~2=187.187、47.399,P<0.05）。程序化诊断特异度低于普通支气管镜、经支气管镜肺活检、CT定位经皮肺穿刺活检，差异有统计学意义（χ~2=49.730,P<0.05）。CT定位经皮肺穿刺活检、程序化诊断敏感度、准确度对比，差异无统计学意义（P>0.05）。结论：程序化诊断在恶性孤立性肺结节鉴别诊断中有较高诊断价值，可为临床制定治疗方案提供参考。更多还原

【Abstract】 Objective:To explore the diagnostic value of programmed diagnosis in malignant solitary pulmonary nodules.Methods: A total of 156 patients with highly suspected malignant solitary pulmonary nodules in the hospital from July 2018 to July 2020 were selected as the research subjects. Ordinary bronchoscopy, transbronchial lung biopsy, and CT localization percutaneous lung biopsy were performed in sequence until the diagnosis was confirmed. The value of programmed diagnosis and isolated diagnosis of malignant solitary pulmonary nodules was compared. Results: Among the 156 patients with highly suspected malignant solitary pulmonary nodules, 103 were diagnosed as malignant by surgical resection or by follow-up, and 82 were diagnosed as malignant by bronchoscopy lung biopsy, with a diagnosis rate of 61.65%. 51 cases of undiagnosed malignancy, malignant lesions manifested as new organisms with necrosis, bronchial orifice stenosis, infiltration, thickening, uneven surface, and occlusion of the orifice. 43 cases of malignancy were diagnosed by CT localization percutaneous lung biopsy, and the diagnosis rate was 84.31%.There were still 8 cases of undiagnosed malignancy after programmed diagnosis. The diagnosis rate of programmed diagnosis of malignant solitary pulmonary nodules was higher than that of ordinary bronchoscopy, transbronchoscope lung biopsy, and CT location percutaneous lung biopsy, and the difference was statistically significant(χ~2=224.271, P<0.05). The sensitivity and accuracy of programmed diagnosis and CT positioning percutaneous lung biopsy were higher than those of bronchoscopy lung biopsy and ordinary bronchoscopy, and the difference was statistically significant(χ~2=187.187, 47.399, P<0.05). The specificity of programmed diagnosis was lower than that of ordinary bronchoscopy, transbronchoscope lung biopsy, and CT positioning percutaneous lung biopsy, the difference was statistically significant(χ~2=49.730, P<0.05). There was no statistically significant difference in the sensitivity and accuracy of CT positioning percutaneous lung biopsy and programmed diagnosis(P>0.05). Conclusion: Programmed diagnosis has high diagnostic value in the differential diagnosis of malignant solitary pulmonary nodules, and can provide references for clinical treatment plans.更多还原