CT引导下经皮肺穿刺活检术诊断肺占位病变的研究  

The Value of CT-guided Percutaneous Lung Biopsy in the Diagnosis of Pulmonary Space-occupying Lesions

作　　者：张蕊 任徽[1] ZHANG Rui;REN Hui(Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,Shaanxi,China;Xi'an Jiaotong University,Xi'an 710061,Shaanxi,China)

机构地区：[1]西安交通大学第一附属医院呼吸与危重症医学科

出　　处：《医学信息》2019年第17期97-99,共3页Journal of Medical Information

摘　　要：目的探讨CT引导下经皮肺穿在诊断肺部占位性病变中的价值及安全性。方法选择2008年1月1日~2018年1月1日于西安交通大学第一附属医院呼吸与危重症医学科,住院行CT引导下经皮肺部穿刺活检的肺占位性病变患者的临床和病理资料,分析其病理类型及诊断准确率、穿刺并发症发生情况及可能的影响因素。结果本研究共收集患者946例,活检次数968次,其中18例进行了二次活检,4例进行了三次活检,术后确诊897例,确诊率94.82%,其中恶性肿瘤526例(包括鳞癌154例,腺癌313例,小细胞癌49例,腺鳞癌10例)。术后主要并发症为气胸、咯血、肺内出血,总发生率为9.83%(93/946),上述并发症均自行好转,未出现严重并发症。高龄(≥70岁)、伴有COPD、病灶大小<3cm的肺占位病变,行CT引导下经皮肺穿气胸发生率较高(P<0.05);发生气胸和未发生气胸患者在性别、病灶部位方面比较,差异无统计学意义(P>0.05)。结论CT引导下经皮肺穿刺活检对肺部占位性病变的诊断有重要临床价值,其活检成功率和确诊率高,并发症发生率低,但对于高龄、病灶小、伴有COPD的需注意气胸的发生。Objective To investigate the value and safety of CT-guided percutaneous lung puncture in the diagnosis of pulmonary space-occupying lesions.Methods From January 1,2008 to January 1,2018,in the Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Xi'an Jiaotong University,the clinical practice of CT-guided percutaneous lung biopsy for patients with lung occupying lesions And pathological data,analysis of pathological types and diagnostic accuracy,puncture complications and possible influencing factors.Results A total of 946 patients were collected in this study.The number of biopsies was 968.Among them,18 underwent secondary biopsy,4 underwent three biopsy,and 897 were diagnosed.The diagnosis rate was 94.82%,including 526 malignant tumors(including squamous cell carcinoma 154,there were 313 cases of adenocarcinoma,49 cases of small cell carcinoma,and 10 cases of adenosquamous carcinoma.The main postoperative complications were pneumothorax,hemoptysis,and intrapulmonary hemorrhage.The total incidence was 9.83%(93/946).The above complications were all improved and no serious complications occurred.Elderly patients(≥70 years old),with COPD and lesion size<3 cm,had a higher incidence of percutaneous lung pneumothorax under CT guidance(P<0.05).Patients with pneumothorax and non-pneumothorax were in gender.There was no significant difference in the lesions(P>0.05).Conclusion CT-guided percutaneous lung biopsy has important clinical value in the diagnosis of pulmonary space-occupying lesions.The biopsy success rate and diagnosis rate are high,and the incidence of complications is low.However,attention should be paid to the elderly,small lesions,and COPD.The occurrence of pneumothorax.

关 键 词：经皮肺穿刺 CT引导 活检 肺结节 并发症 

分 类 号：R816.4[医药卫生—放射医学]