超声引导下经皮肺穿刺活检术在艾滋病周围型肺部病变中的应用价值  

Application value of ultrasound-guided percutaneous lung biopsy in AIDS patients with peripheral pulmonary lesions

作　　者：王俊东[1] 刘长珠[1] 李宝金[2] 陈劲峰[3] 张影[2] 张志平[4] 

机构地区：[1]广州市第八人民医院超声科,广州510060 [2]广州市第八人民医院普外科,广州510060 [3]广州市第八人民医院感染科,广州510060 [4]广州市第八人民医院放射科,广州510060

出　　处：《广州医药》2017年第3期57-59,67,共4页Guangzhou Medical Journal

基　　金：广州市科技计划项目(201609010020)

摘　　要：目的探讨超声引导下经皮肺穿刺活检术在艾滋病周围型肺部病变中的应用价值。方法我院52例经皮肺穿刺活检的病例,术前均采用高效抗逆转录病毒治疗,依据CD4+T淋巴细胞确定是否手术,术中规范手术方式,做好防护措施,27例行超声引导穿刺,25例行CT引导穿刺,术后应用抗生素预防机会性感染等。结果所有患者穿刺成功率100%,超声组肺结核13例,真菌感染67例,细菌感染4例,肺腺样囊性癌2例、卡波西肉瘤1例。CT组肺结核11例,真菌感染7例,细菌感染5例,肺腺样囊性癌1例。术后并发症:超声组5例病灶少量气胸,2例周围少量出血,咯血4例;CT组8例病灶少量气胸,4例周围少量出血,咯血7例。结论经过术前控制患者计数及预防感染治疗,超声引导下经皮肺穿刺活检术在艾滋病周围型肺部病变中应用更为安全、有效、可行的,值得临床应用及推广。Objective Objective to investigate the value of ultrasound-guided percutaneous lung biopsy in the diagnosis of peripheral lung lesions in AIDS patients. Methods 52 cases in our hospital of percutaneous pulmonary biopsy cases, preoperative highly active antiretroviral therapy was used, basis of CD4＋ T lymphocytes count determined whether the operation were performed, standard operation mode in the operation. It must to take good protective measures. 27 cases underwent ultrasound guided puncture, 25 cases underwent CT guided puncture and had postoperative application of antibiotics to prevent opportunistic infections. Results The successful rate of puncture was 100% in all patients. Tuberculosis in the ultrasound group was 13 cases, fungal infection was 67 cases, bacterial infection was 4 cases, pulmonary adenoid cystic carcinoma was 2 cases, and Posey＇s sarcoma was 1 cases. There were 11 cases of pulmonary tuberculosis in CT group, 7 cases in fungal infection, 5 cases in bacterial infection, and 1 cases in adenoid cystic carcinoma of the lung. Postoperative complications included： 5 cases of small pneumothorax in the ultrasound group, a small amount of bleeding around the surrounding, hemoptysis in 4 cases, CT group of patients with 8 cases of a small amount of pneumothorax in the lesions, 4 cases of a small amount of bleeding around the case, 7 cases of hemoptysis. Conclusion After preoperative control count and prevention of infection in patients with treatment, ultrasound guided percutaneous lung biopsy in peripheral pulmonary lesions of AIDS is more safe and effective, worthy of clinical application and promotion.

关 键 词：穿刺活检术 获得性免疫缺陷综合征 CD4+T淋巴细胞 肺部病变 

分 类 号：R445.1[医药卫生—影像医学与核医学] R512.91[医药卫生—诊断学]