目的：比较传统经支气管镜肺活检（TBLB）、径向超声引导的肺活检（RP-EBUS-TBLB）对周围型肺癌的诊断差异，探讨抛弃式超声探头导引鞘（GS）的临床使用价值。方法：回顾分析经支气管镜检查的268例周围性肺癌患者的临床资料，按照不同的检查方法分为TBLB组（107例）、RP-EBUS-TBLB组（104例）和GS-RP-EBUS-TBLB（57例）三组，比较各组之间的诊断率，分析其相关影响因素。结果：1.TBLB、RP-EBUS-TBLB和GS-RP-EBUS-TBLB组的诊断阳性率分别为45.8%、61.5%和63.2%，和TBLB相比差异均有统计学意义（P<0.05）；2.GS-RP-EBUS-TBLB组和RP-EBUS-TBLB组刷检阳性率分别为52.7%和41.0%，差异有统计学意义（P<0.05）；3.GS-RP-EBUS-TBLB和RP-EBUS-TBLB组在半实性、支气管征阴性和超声毗邻型病灶的刷检阳性率分别为66.7%和53.3%、25.0%和18.2%、58.3%和39.4%，差异有统计学意义（P<0.05）。结论：GS-RP-EBUS-TBLB可以提高周围性肺癌刷检阳性率，增加半实性、支气管征阴性和超声毗邻型病灶的诊断阳性率。

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