CT引导下经皮肺穿刺活检的应用和并发症的防治  

The clinical application and prevention of complication of CT-guide percutaneous lung puncture biopsy

作　　者：朱艳清[1] 张军[1] 赵恒柏[1] 赵小兵[1] 朱海云[1] 柏挺[1] 

机构地区：[1]解放军第85医院放射科,上海200052

出　　处：《东南国防医药》2007年第2期112-113,116,共3页Military Medical Journal of Southeast China

摘　　要：目的探讨CT引导下经皮肺穿刺活检的应用价值、并发症及其防治方法。方法对61例肺部病变患者进行了经皮穿刺,肺结节或肿块的直径为0.9-10.8cm(平均直径3.8cm)。由CT监视穿刺针的路径和位置,并测量进针的深度和角度。穿刺成功的病例均行细胞学及病理学检查。结果61例中确定病理诊断56例,其中腺癌31例、鳞癌8例、未分化癌3例、查到癌细胞但未能分型2例、肺脓肿6例、肺结核3例和炎性假瘤3例;失败和未明确诊断5例。发生气胸5例,针道渗血3例,少量咯血2例,血胸1例。穿刺活检总确诊率为91.8%。结论CT引导下经皮肺穿刺活检是一种定位准确、安全可靠、阳性诊断率高的检测方法,少数患者出现并发症。Objective To study the clinical application,complication and method of prevention of CT-guide percutaneous lung puncture biopsy. Methods All of 61 cases which lung nodes or lamps diameter were from 0.9cm to 10.8cm （mean diameter 3.8cm） were punctured through skin. The path and local were monitored by CT scan, and the depth and the angle of entering needle were measured. The cytology and histology check were made in all of successfully cases. Results Of 61 cases, 56 cases were correctly diagnosed, including adenocarcinoma （n = 31 ）, squamouscarcinoma （n = 8 ）, undifferentiated carcinoma （n = 3） and unclassified carcinoma（n = 2）. And 12 cases were confirmed to be benign lesions, including lung abscess （n = 6）, tuberculosis（n = 3） and inflammatory pseudotumor（n= 3）. Failing in 5 cases. The number of pneumothorax, capillary hemorrhage , hemoptysis and hemothorax were 5, 3, 2 and 1 respectively. The accuracy rate was 91.8%.Conclusion CT-guide percutaneous lung puncture biopsy is a safe accurate and successful efficient diagnostic method with low rate of complication.

关 键 词：CT 肺 穿刺活检 并发症 

分 类 号：R814.42[医药卫生—影像医学与核医学]