The application of ultrasound bronchoscopy combined with mNGS in the etiological diagnosis of pneumonia with poor absorption and dissipation / 重庆医学

ABSTRACT

Objective To explore the clinical value of ultrasound bronchoscopy combined with met-agenomic next-generation sequencing(mNGS)in the etiological diagnosis of pneumonia with poor absorption and dissipation.Methods The clinical data of the patients with pneumonia with poor absorption and dissipa-tion in this hospital from January 2022 to February 2023 were retrospectively collected.Among them,73 cases received the endobronchial ultrasound guided tranbronchial needle aspiration(EBUS-TBNA)and 36 cases re-ceived endobronchial ultrasound transbronchial lung biopsy using guide sheath(EBUS-GS-TBLB).The distri-bution of causes and incidence of examination related complications were analysed.Results The results of ul-trasound bronchoscopy combined with mNGS examination showed that the benign lesions accounted for 33.03％,mainly chronic inflammation(9.17％)and infectious disease(20.18％),and tuberculosis was the main cause of infectious diseases(7.34％).The malignant lesions accounted for 57.80％,mainly adenocarcinoma(28.44％).The diagnostic positive rate was 90.83％,and no definite diagnosis accounted for 9.17％.There was no statistically significant difference in the diagnostic positive rate between the patients receiving EBUS-TBNA combined with mNGS examination and the patients receiving EBUS-GS-TBLB combined with mNGS examination(94.52％vs.83.33％,P＞0.05),and there was no statistically significant difference in the inci-dence rates of complications such as less bleeding,anoxia,pneumothorax and delayed resuscitation.No serious complications such as mediastinal emphysema,large vessel injury,shock and death were observed in all pa-tients.Conclusion Ultrasound bronchoscopy combined with mNGS has the characteristics of high diagnostic positive rate and few complications in the etiological diagnosis of pneumonia with poor absorption and dissipa-tion.It can help clinical physicians clarify the diagnosis as soon as possible,and may become a new method for diagnosing respiratory system diseases in recent years.