CT导引下经皮穿刺肺活检术取材方法对不同大小的肺部病变诊断价值及安全性的研究  

Diagnostic values and safety of ct-guided lung biopsy of different-sized malignant lesions sampling methods

作　　者：刘运秋[1] 王丽晔[1] 唐晓霞[1] 李学英[1] 刘景旺[1] 刘淑芬[1] 刘向欣[1] 韩林华[1] 

机构地区：[1]河北联合大学附属开滦总医院呼吸内科,河北唐山063000

出　　处：《中国现代医学杂志》2013年第31期108-112,共5页China Journal of Modern Medicine

摘　　要：目的探讨CT导引下经皮穿刺肺活检术三种取材方法对不同大小的肺部病变诊断价值和安全性。方法适合CT导引下经皮穿刺肺活检术的肺部肿块或结节患者,随机分为切割活检组、针吸活检组及切割加针吸活检组,共206例,经手术病理、临床综合分析+临床随访符合恶性肿瘤者共138例,其中切割活检组47例,针吸活检组45例,切割加针吸活检组46例。比较三种取材方法不同大小的肺部病变诊断价值和安全性。结果①206例CT导引下经皮穿刺肺活检术总的诊断正确率为74.76%(154/206),病灶直径<3 cm组与直径≥3 cm组诊断正确率分别为54.26%(51/94)和91.96%(103/112),差异有显著性(χ2=38.5104,P=0.0001)。直径<3 cm的病灶中,切割加针吸组的诊断正确率最高,差异有显著性(χ2=7.9762,P=0.0185)。直径≥3 cm的病灶中,三组差异无显著性(Fisher's精确检验P=0.2110)。②病灶直径<3 cm组与直径≥3 cm组的气胸发生率分别为12.77%(12/94)和0%(0/112),出血发生率分别为12.77%(12/94)和3.57%(4/112),差异均有显著性(Fisher’s精确检验,气胸χ2=15.1823,P<0.0001;出血χ2=6.0311,P=0.0141)。结论 CT导引下经皮穿刺肺活检术中,直径≥3 cm组诊断正确率高,并发症低。【Objective】To compare the diagnostic values and safety of three sampling methods based on the di- agnostic accuracy of different-sized malignant lesions of the lungs. 【Methods】A total of 206 patients with lung masses or nodules underwent CT-guided percutaneous lung biopsy. And 138 of them were diagnosed as having pul- monary malignant lesions by surgical pathology, clinical features and follow-up, including cutting biopsy group of 47 patients, needle aspiration group of 40 patients, and cutting plus needle aspiration biopsy 50 patients. The diagnostic accuracies of different-sized malignant lesions of the lungs by the three sampling methods were compared.【Re- sults】① The overall diagnostic accuracy rate of 206 cases of CT-guided percutaneous lung biopsy was 74.76%（154/206）, the diagnostic accuracy rate in group whose lesions of diameter smaller than three centimeters was 54.26%（51/94） and in group whose lesions of diameter greater than three centimeters was 91.96%（103/112）（χ2= 38.5104, P =0.0001）. ②For malignant on histopathological type, the accurate diagnosis rate of cutting and needle aspiration biopsy was highest in three different methods in group whose lesions of diameter smaller than three cen- timeters（χ2=23.8515, P 0.001）. The accurate diagnosis rates were not statistically different in three different meth- ods in group whose lesions of diameter greater than three centimeters（Fisher＇s exact test P =0.2110）. ③The inci- dence of pneumothorax in group whose lesions of diameter smaller than three centimeters（12.77%, 12/94） higher than in group whose lesions of diameter greater than three centimeters（0%, 0/112; χ2=15.1823, P 0.0001）. The incidence of bleeding in group whose lesions of diameter smaller than three centimeters（12.77%, 12/94）was higher than in group whose lesions of diameter greater than three centimeters（3.57%, 4/112, χ2=6.0311, P =0.014）.【Conclusion】In CT-guided percutaneous lung biopsy, diagnostic accuracies rate was higher a

关 键 词：经皮穿刺肺活检术 不同大小的肺部病变 取材方法 诊断价值 安全性 

分 类 号：R563[医药卫生—呼吸系统]