Objective: To compare the diagnostic rate and safety of postoperative complications between transbronchial cryobiopsy (TBCB) and transbronchial lung biopsy (TBLB) in patients with lung transplantation. Methods: A retrospective analysis of patients who underwent TBCB or TBLB in the Department of Lung Transplantation in China-Japan Friendship Hospital from June 2017 to June 2024 was conducted to determine the postoperative complications and analyze clinical characteristics, procedures, diagnostic rates and safety. Results: Thirty-five and 153 patients with lung transplantation received TBCB and TBLB, respectively. Patients who received TBCB had lower preoperative oxygenation index (t'=2.4, P<0.01). Meanwhile, the pathological diagnosis rate (85.7% vs. 45.7%, χ²=18.27, P<0.01) and clinical diagnosis rate (94.2% vs. 69.9%, χ²=8.80, P<0.01) of patients who received TBCB were significantly higher than those who received TBLB. There was no significant difference in the incidence of severe bleeding (2.9% vs. 0.7%, χ²=1.3, P=0.86) and pneumothorax (0 vs. 3.9%, χ²=0.43, P=0.24) between patients receiving TBCB and TBLB. The most common complications after lung transplantation in the group of TBCB were chronic lung allograft dysfunction (45.4%, 15/33), antibody mediated rejection (18.2%, 6/33) and organizing pneumonia (12.2%, 4/33). While antibody mediated rejection (29.9%, 32/107), chronic lung allograft dysfunction (16.8%, 18/107), and pneumonia (16.8%, 18/107) were more frequent in the patients who received TBLB. Conclusions: TBCB has a high diagnostic value for postoperative complications after lung transplantation, with an acceptable complication rate of bleeding and pneumothorax.
目的： 比较经支气管肺冷冻活检（TBCB）和经支气管肺活检（TBLB）在肺移植术后并发症的诊断率和安全性。 方法： 回顾性分析中日友好医院肺移植科2017年6月至2024年6月间连续接受TBCB或TBLB的肺移植术后患者，以确定其术后并发症，并分析患者临床特征、操作流程、诊断率及安全性。 结果： 35例和153例肺移植术后患者分别接受了TBCB和TBLB，接受TBCB的患者操作前氧合指数更低（t=2.4，P<0.01），接受TBCB的患者病理诊断率（85.7% vs 45.7%，χ²=18.27，P<0.01）和临床诊断率（94.2% vs 69.9%，χ²=8.80，P<0.01）明显高于接受TBLB的患者。接受TBCB和TBLB的患者重度出血发生率（2.9% vs 0.7%，χ²=1.30，P=0.86）和气胸的发生率（0 vs 3.9%，χ²=0.43，P=0.24）差异无统计学意义。接受TBCB患者肺移植术后常见并发症为慢性肺移植物功能障碍（45.4%，15/33）、抗 体 介 导 排 异 反 应（18.2%，6/33）、机化性肺炎（12.2%，4/33），而TBLB患者为抗 体 介 导 排 异 反 应（29.9%，32/107）、慢性肺移植物功能障碍（16.8%，18/107）、肺炎（16.8%，18/107）。 结论： TBCB对于肺移植术后的并发症诊断价值高，出血和气胸风险可控。.