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中华肺部疾病杂志(电子版) ›› 2026, Vol. 19 ›› Issue (04) : 696 -700. doi: 10.3877/cma.j.issn.1674-6902.2026.04.026

综述

超声支气管镜引导下经支气管纵隔冷冻活检围术期安全管理现状与进展
王瑶, 王霞(), 张硕辛   
  1. 400037 重庆,陆军(第三)军医大学第二附属医院呼吸与危重症医学中心
  • 收稿日期:2026-04-13 出版日期:2026-08-25
  • 通信作者: 王霞

Current status and research progress of perioperative safety management of transbronchial mediastinal cryoablation guided by ultrasound bronchoscopy

Yao Wang, Xia Wang(), Shoshin Zhang   

  • Received:2026-04-13 Published:2026-08-25
  • Corresponding author: Xia Wang
引用本文:

王瑶, 王霞, 张硕辛. 超声支气管镜引导下经支气管纵隔冷冻活检围术期安全管理现状与进展[J/OL]. 中华肺部疾病杂志(电子版), 2026, 19(04): 696-700.

Yao Wang, Xia Wang, Shoshin Zhang. Current status and research progress of perioperative safety management of transbronchial mediastinal cryoablation guided by ultrasound bronchoscopy[J/OL]. Chinese Journal of Lung Diseases(Electronic Edition), 2026, 19(04): 696-700.

超声支气管镜引导经支气管针吸活检术(endobronchial ultrasound-guided transbronchial needle aspiration, EBUS-TBNA)是纵隔及肺门病变诊断的首选方法,但在诊断淋巴瘤、结节病及满足分子检测样本需求上存在局限。超声支气管镜引导经支气管纵隔冷冻活检术(EBUS-guided transbronchial mediastinal cryobiopsy, EBUS-TMC)自2020年首次临床应用以来,凭借其标本量大、组织架构完整的优势,被多项随机对照试验证实可显著提高上述疾病的诊断率,成为EBUS-TBNA之外纵隔诊断的重要补充手段。但作为一项应用史不足5年的新技术,EBUS-TMC在出血分级标准、冷冻参数、麻醉方式及培训准入等关键环节仍缺乏统一共识,各中心实践差异明显,尚未形成标准化操作规范。围术期安全管理体系的建立与完善,是决定该技术能否规范化推广并在更多中心安全开展的核心前提。本文系统总结了EBUS-TMC并发症与发生率的现有证据,分别从适应证筛选与术前影像学评估、麻醉方式与团队准备、术中操作流程、术中监测与团队配合、并发症处理、术后观察与迟发性并发症随访以及学习曲线与质量控制几个层面梳理围术期安全管理的关键问题,同时对出血分级标准不统一、中度镇静与全身麻醉的选择争议、准入例数缺失和经工作通道取样等新技术的验证需求进行述评,为该技术的规范化开展提供参考。

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