CT引导下经皮肺穿刺在延迟吸收性肺炎患者中的应用价值  

Value of CT-guided percutaneous lung biopsies in patients with slowly resolving pneumonia

作　　者：张鹏宇[1] 张国清[1] 季勇 张旻[1] ZHANG Peng-yu;ZHANG Guo-qing;JI Yong;ZHANG Min(Department of Respiratory and Critical Care Medicine,Shanghai General Hospital Affiliated to Shanghai Jiaotong University,Shanghai 200080,China)

机构地区：[1]上海交通大学附属第一人民医院呼吸与危重症医学科,上海200080

出　　处：《临床肺科杂志》2020年第11期1631-1635,共5页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨CT引导下经皮肺穿刺在延迟吸收性肺炎患者中的应用价值。方法回顾性分析146例因延迟吸收肺炎行CT引导下经皮肺穿刺患者的临床资料。结果 146例患者中,71例(71/146,48.6%)通过经皮肺穿刺获得了明确诊断,70例(70/146,47.9%)经皮肺穿刺的结果为非特异性的。5例患者(5/146,3.4%)经皮肺穿刺未能成功。71例诊断明确的患者包括:肺结核23例,真菌性肺炎5例,肺部恶性肿瘤23例,机化性肺炎15例;其他5例(肺泡蛋白沉积症1例,肺梗死1例,尘肺1例,炎性假瘤1例,间质性肺炎1例)。从肺穿刺到得到明确病理诊断的时间平均为4天。并发症主要为气胸,为51例(占总数的34.9%),其中大多数(48例,94.1%)为少量气胸,无需特别处理,其中3例(占总数的2.1%)进行了胸腔闭式引流。出血10例(6.8%),均为少量出血,无大咯血。无肺穿刺相关死亡病例。结论 CT引导下经皮肺穿刺在延迟吸收性肺炎的诊断中有较好的应用价值和安全性。最常见的病因为结核和真菌感染。Objective To investigate the value of CT-guided percutaneous lung biopsy in patients with slowly resolving pneumonia.Methods The clinical data of patients undergoing CT-guided percutaneous lung puncture for slowly resolving pneumonia were retrospectively analyzed.Results 146 patients with slowly resolving pneumonia underwent CT-guided percutaneous lung biopsy.The biopsy provided a diagnosis in 71 patients(71/146,48.6%),whereas the biopsy results were nondiagnostic in the remaining 70 patients(70/146,47.9%).The biopsy was not successful in 5 patients(5/146,3.4%).The 71 patients with clear diagnosis included:tuberculosis(n=23),fungal pneumonia(n=5),malignant lung tumors(n=23),organizing pneumonia(n=15),alveolar proteinosis(n=1),pulmonary infarction(n=1),pneumoconiosis(n=1),inflammatory pseudotumor(n=1),and interstitial pneumonia(n=1).The average time from lung biopsy to diagnosis was 4 days.The main complication was pneumothorax in 51 patients(34.9%of the total),most of them(n=48,94.1%)were small amount of pneumothorax without special treatment,and 3 of them(2.1%of the total)underwent chest tube drainage.Bleeding occurred in 10 patients(6.8%),all with minor bleeding and no massive hemoptysis.No lung biopsy-related death reported.Conclusion CT-guided percutaneous lung biopsy has good application value and safety in the diagnosis of slowly resolving pneumonia.Organisms identified in these patients are most frequently tuberculosis and fungi.

关 键 词：CT引导下 肺穿刺活检 延迟吸收性肺炎 

分 类 号：R563.1[医药卫生—呼吸系统]