艾滋病并发症中CT引导下经皮肺穿刺活检术的应用  

Diagnostic Value and Occupation Protection of CT Guided Transthoracic Needle Biopsy in the Lung Complications of AIDS Patients

作　　者：朱文科[1] 黄湘荣[1] 陆普选[1] 张莉萍[1] 李苑[1] 刘锦清[1] 曹义[1] 张辉[1] 刘水腾[2] 刘艳[2] 乐晓华[3] 

机构地区：[1]深圳市第三人民医院放射科,广东518020 [2]深圳市第三人民医院艾滋病区,广东518020 [3]深圳市第三人民医院病理科,广东518020

出　　处：《放射学实践》2009年第10期1064-1066,共3页Radiologic Practice

基　　金：深圳市卫生局重点科技项目资助(200607);深圳市科技计划项目(200903091)

摘　　要：目的:探讨CT引导下经皮穿刺活检术在艾滋病肺部病变中的应用、诊断价值及其暴露防护。方法:回顾性分析16例经皮肺穿刺活检的相关资料,男10例,女6例,平均年龄28.7岁;其中单个病灶7例,多发块影或结节影5例,大片实变影4例,合并纵隔淋巴结肿大4例,合并胸水3例。结果:所有病例均穿刺成功,16例患者行18例次穿刺,12例病例获得诊断,其中肺结核6例,真菌感染3例,细菌感染3例,诊断符合率66.7%;不能明确诊断4例。术后并发症:病灶周围出血5例,少量气胸3例。无医护人员暴露感染。结论:CT引导下经皮肺穿刺活检较为安全,有利于患者早期诊断,操作应严格预防暴露感染。Objective：To explore the diagnostic value and occupation protection of CT guided transthoracic needle biopsy in the pulmonary complications of AIDS patients. Methods：The data of 16 AIDS patients with lung complications who underwent CT-guided percutaneous transthoracic needle aspiration biopsy were retrospectively analyzed. There were ten male patients and six female patients （mean age, 28.7 years）, including 7 cases with single node or mass, 5 cases with multiple nodes or masses,4 cases with large patches of consolidation, 4 cases with mediastinum lymphadenopathy,and 3 cases with pleural fluid. Results：The procedures for all patients were carried out successfully. Among the 16 cases undergoing bi opsy 18 times,diagnosis was made in 12 cases,including pulmonary tuberculosis in 6 cases, fungal infection in 3 cases, and bacterial infection in 3 cases. The diagnostic accuracy was 66.7%. Complications of biopsy included the bleeding surrounding the lesions （5 cases） and mild pneumothorax （3 cases）. No medical staff developed hospital acquired infection due to the biopsy procedure. Conclusion： CT-guided percutaneous transthoracic needle aspiration biopsy in AIDS patients with lung complications is safe and valuable for early diagnosis. Exposure infection should be strictly prevented.

关 键 词：体层摄影术 X线计算机 获得性免疫缺陷综合征 活组织检查 针吸 

分 类 号：R512.91[医药卫生—内科学] R814.42[医药卫生—临床医学]