全自动与半自动活检针在CT引导经皮肺穿刺活检中的临床应用  

Clinical application of automatic and semi-automatic biopsy needles under CT-guided percutaneous puncture lung biopsy

作　　者：宋树玺[1] 徐龙[1] 张冠中[1] 郑振东[1] SONG Shuxi;XU Long;ZHANG Guanzhong;ZHENG Zhendong(Department of Oncology,Cancer Treatment Center,General Hospital of Shenyang Military Region,Shenyang 110840,China)

机构地区：[1]沈阳军区总医院全军肿瘤诊治中心肿瘤科,沈阳110016

出　　处：《临床肿瘤学杂志》2018年第8期739-742,共4页Chinese Clinical Oncology

基　　金：中华国际医学交流基因会基金资助项目(Z-2014-06-16342)

摘　　要：目的比较全自动式和半自动式两种活检针在CT引导下肺穿刺活检术的临床应用。方法回顾2015年3月至2016年10月于本院进行CT引导下经皮肺穿刺活检术患者242例,其中157例使用全自动活检针(全自动组),余85例使用半自动活检针(半自动组),比较两组的穿刺成功率、充足标本率、诊断效能(准确率、敏感性和特异性)及常见并发症的发生率。结果两组的穿刺成功率均为100.0%,全自动组的充足标本率为100.0%(157/157),高于半自动组的95.3%(81/85),差异有统计学意义(P<0.05);全自动组的特异度和准确率分别为91.7%(22/24)和98.1%(154/157),均高于半自动组的70.0%(7/10)和准确率为92.6%(74/81),差异有统计学意义(P<0.05),但全自动组和半自动组的敏感度为99.2%(132/133)和94.4%(67/71),差异无统计学意义(P>0.05)。全自动组针道出血的发生率为33.8%,高于半自动组的21.2%(P<0.05),两组气胸、血胸、痰中带血、穿刺相关感染、空气栓塞和和胸膜反应发生率的差异无统计学意义(P>0.05)。结论 CT引导经皮肺肿物穿刺活检术操作中,两种活检针各有优缺点,仅适用范围不同,全自动活检针充足标本率、诊断准确率和特异性更高,并发症可控,半自动活检针针道出血风险小。Objective To compare the clinical application of automatic biopsy needle and semi-automatic biopsy needle underCT guided lung biopsy. Methods Two hundred and forty-two cases of percutaneous lung biopsy under CT guidance from March 2015to October 2016 were performed in our hospital. Among them, 157 cases were performed with automatic biopsy needle （ automaticgroup）, and 85 cases with semi-automatic biopsy needle （semi-automatic group）. The puncture success rate, sufficient specimen rate,diagnostic efficacy （accuracy, sensitivity and specificity） and the incidence of common complications were compared between bothgroups. Results The puncture success rates were 100. 0% in both groups. The sufficient specimen rate of the automatic group was100. 0% （157 / 157）, higher than 95. 3% （81 / 85） of the semi automatic group （P〈0. 05）. The specificity and accuracy of the auto-matic group were 91. 7% （22 / 24） and （154 / 157）, higher than 91. 7% （22 / 24） and 98. 1% （154 / 157） of semi-automatic group （P〈0. 05）. However, the sensitivity was 99. 2% （132 / 133） and 94. 4% （67 / 71） in the automatic group and the semi-automatic group（P〉0. 05）. The incidence of needle bleeding was 33. 8% in automatic group, higher than 21. 2% of the semi-automatic group （P〈0. 05）. There was no significant difference between incidences of pneumothorax, hemothorax, blood in phlegm, puncture-related infec-tion, air embolism and pleural reaction in both groups （P〉0. 05）. Conclusion In the operation of CT guided percutaneous lung masspuncture biopsy, two kinds of needle biopsy needles have the advantages and disadvantages, and only the applicable range is different.The automatic biopsy needle is sufficient with higher diagnostic accuracy and specificity. The semiautomatic needle biopsy needle has little risk of bleeding.

关 键 词：肺癌 CT引导经皮肺穿刺活检 全自动活检针 半自动活检针 

分 类 号：R734.2[医药卫生—肿瘤]