三维立体定向仪在肺内小结节经皮活检中的应用  

Application of 3D-Stereotactic Apparatus in Patients with Small Pulmonary Nodule by Needle Biopsy of Lung

作　　者：肖天林[1] 徐细明[1] 戈伟[1] 

机构地区：[1]武汉大学人民医院肿瘤科,湖北武汉430060

出　　处：《武汉大学学报（医学版）》2015年第6期922-925,共4页Medical Journal of Wuhan University

摘　　要：目的:评价三维立体定向仪在≤2cm肺部小结节CT引导下经皮肺穿活检术中的临床应用价值。方法:收集武汉大学人民医院及湖北省襄阳市中心医院经皮肺穿活检术且肺内≤2cm占位性病变患者的临床资料,随机将使用CT引导下直接穿刺活检的患者定义为A组(n=55),使用三维立体定向仪穿刺活检的患者定义为B组(n=59),再按照病灶直径分成A1、B1(1cm≤直径≤2cm)及A2、B2(直径<1cm),比较两组穿刺成功率、并发症的发生率、穿刺时间及穿刺次数。结果:A2组穿刺成功率为70.83%,B2组为95.65%,P=0.048;B1组穿刺时间及穿刺次数均小于A1组(P<0.05),B2组穿刺时间及穿刺次数均小于A2组(P<0.01);气胸及咯血并发症的发生率A组为40.0%,B组为20.34%,P=0.022。结论:三维立体定向仪指导下穿刺成功率比CT引导下穿刺成功率更高,且穿刺时间短、穿刺次数少,对组织损伤少,尤其对于病灶越小,穿刺成功率越高,气胸及咯血并发症的发生率更少,三维立体定向仪指导下精确穿刺肺小结节病变技术成熟、值得广泛推广应用。Objective：To evaluate clinical application of CT-guided 3D-Stereotactic apparatus in patients with ≤2cm diameter pulmonary nodule.Methods：The patients received needle biopsy of lung with ≤2cm diameter pulmonary nodule were analyzed.The patients received CT-guided needle biopsy of lung were randomly divided into A group（n=55）,and the patients received 3D-stereotactic apparatus needle biopsy of lung were subdivided into B group（n=59）.The patients were subdivided into A1,B1group（1cm≤ diameter≤2cm）and A2,B2group（diameter1cm）according to the diameter of pulmonary nodule on CT.The biopsy diagnosis accuracy rate,the incidence of complication,needling duration and needling number were compared between two groups.Results：The diagnosis accuracy rate of A2 group and B2 group was 70.83% and95.65%,respectively,with a statistical difference（P=0.048）.The patients of B1 and B2group were given less needling number biopsy and shorter duration needling biopsy（P〈0.05;P〈0.01,respectively）,as compared with group A1 and group A2.The incidence of complications in A group and B group were 40.0% and 20.34% respectively,and the difference was statistically significant（P=0.022）.Conclusion：Diagnostic accuracy rate of 3D-stereotactic guided apparatusneedle biopsy of lung nodules is higher than that in the CT-guided needle biopsy group,with a less needling number biopsy and a shorter duration needling biopsy,and the complication rate of3D-stereotactic guided apparatus group is lower.So 3D-stereotactic guided apparatus needle biopsy of lung nodules is successful and worthy of wider application in clinical practice.

关 键 词：CT引导 经皮肺穿活检术 三维立体定向仪 肺结节 

分 类 号：R739.62[医药卫生—肿瘤] R814.42[医药卫生—临床医学]