本研究的目的是探讨在镇痛和镇静状态下，在常规支气管镜检查室中，不使用气管插管、硬性支气管镜或透视检查的情况下，柔性经支气管冷冻活检 (TBCB) 诊断弥漫性肺实质疾病 (DPLD) 的有效性和安全性或全身麻醉。收集2018年5月至2020年9月桂林医学院附属医院收治的50例病因不明的DPLD患者资料，最终纳入43例。对43例患者的标本进行病理学检查、病原微生物培养等，并采用临床-放射学-病理诊断模式进行分析，以证实TBCB对DPLD病因诊断的有效性。随后，密切观察记录TBCB术中、术后并发症及其严重程度，综合评价TBCB的安全性。纳入的43例患者中，共进行TBCB活检85例（1.98[1, 4]次/例），获得有效组织标本82份（1.91[1, 4]件/例），占96.5%（ 82/85) 的总样本。平均样本尺寸为 12.41 (1, 30) mm2。最终确诊38例，其中特发性肺纤维化11例，结缔组织相关间质性肺病5例，非特异性间质性肺炎5例，肺结核4例，职业性肺损伤4例，间质性肺炎3例具有自身免疫特征，肺癌1例，间质性肺病（未分类间质性肺病）2例，过敏性肺炎1例，肺泡蛋白沉积症1例，真菌感染1例。其余5起案件尚不清楚。传染病总体病原学诊断率为88.4%（38/43）。并发症方面，发生气胸4例（9.3%，4/43，其中轻度1例，中度3例），其中3例（75%）经胸腔引流封闭，1例（25%）吸收无需治疗。此外，根据严重程度评估方法的不同，有22例没有出血（51.2%），21例有不同程度的出血。 TBCB 是一种微创、快速、经济、有效、安全的诊断技术。作者版权所有 © 2024。由 Wolters Kluwer Health, Inc. 出版

The objective of this study is to investigate the efficacy and safety of flexible transbronchial cryobiopsy (TBCB) in the diagnosis of diffuse parenchymal lung disease (DPLD) in a routine bronchoscopy examination room under analgesia and sedation, using neither endotracheal intubation or rigid bronchoscope nor fluoroscopy or general anesthesia. The data from 50 DPLD patients with unknown etiology who were treated in the Affiliated Hospital of Guilin Medical College from May 2018 to September 2020 were collected, and 43 were eventually included. The specimens obtained from these 43 patients were subjected to pathological examination, pathogenic microorganism culture, etc, and were analyzed in the clinical-radiological-pathological diagnosis mode to confirm the efficacy of TBCB in diagnosing the cause of DPLD. Subsequently, the intraoperative and postoperative complications of TBCB and their severity were closely observed and recorded to comprehensively evaluate the safety of TBCB. For the 43 patients included, a total of 85 TBCB biopsies were performed (1.98 [1, 4] times/case), and 82 valid tissue specimens were obtained (1.91 [1, 4] pieces/case), accounting for 96.5% (82/85) of the total sample. The average specimen size was 12.41 (1, 30) mm2. Eventually, 38 cases were diagnosed, including 11 cases of idiopathic pulmonary fibrosis, 5 cases of connective tissue-related interstitial lung disease, 5 cases of nonspecific interstitial pneumonia, 4 cases of tuberculosis, 4 cases of occupational lung injury, 3 cases of interstitial pneumonia with autoimmune characteristics, 1 case of lung cancer, 2 cases of interstitial lung disease (unclassified interstitial lung disease), 1 case of hypersensitivity pneumonitis, 1 case of pulmonary alveolar proteinosis, and 1 case of fungal infection. The remaining 5 cases were unclarified. For infectious diseases, the overall etiological diagnosis rate was 88.4% (38/43). With respect to complications, pneumothorax occurred in 4 cases (9.3%, 4/43, including 1 mild case and 3 moderate cases), of which 3 cases (75%) were closed by thoracic drainage and 1 case (25%) was absorbed without treatment. In addition, 22 cases experienced no bleeding (51.2%) and 21 cases suffered bleeding to varying degrees based on different severity assessment methods. TBCB is a minimally invasive, rapid, economical, effective, and safe diagnostic technique.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.