CT引导下穿刺活检术对边界清晰的孤立性肺小结节的诊断价值研究  

Diagnostic value of CT guided puncture biopsy for well-defined solitary pulmonary nodules

作　　者：王芬[1] 徐海[1] 张伟[1] 张腾[1] 仲艳[1] 刘希胜[1] 俞同福[1] WANG Fen;XU Hai;ZHANG Wei;ZHANG Teng;ZHONG Yan;LIU Xi-sheng;YU Tong-fu(Department of Radiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210029,China)

机构地区：[1]南京医科大学第一附属医院放射科,江苏南京210029

出　　处：《临床肺科杂志》2021年第6期923-929,共7页Journal of Clinical Pulmonary Medicine

摘　　要：目的研究CT引导下经皮穿刺肺活检(CT-PTLB)对肺部边界清晰的孤立性小结节的诊断价值。方法回顾性分析我院2019年1月至2020年2月的117例边界清晰的孤立性肺结节(直径<2.0cm)患者临床资料;117例患者经CT-PTLB采集标本后,病理检查明确病理类型,分为良性病变和恶性病变组、未明确诊断三组,对患者性别、年龄、体位、病灶距胸膜距离、进针点距病灶距离、进针角度分组分析并发症的影响因素。结果117例中114例患者得到诊断结果,良性病变40例,恶性病变组74例。穿刺术后并发症主要为气胸、肺内出血,发生率分别为26.5%(31/117)、57.3%(81/117)。病灶大小与患者年龄为气胸发生的影响因素(P<0.05),进针点距病灶距离与气胸的发生与肺内出血发生相关(P<0.05),进针角度为肺内出血发生的重要影响因素(P<0.05);两种并发症发生在良、恶性病变及未明确诊断三组间无显著差异(P>0.05)。结论CT-PTLB对肺部边界清晰小结节诊断价值高,可为临床诊疗提供参考性,控制并发症的相关影响因素,将更好地服务于临床。Objective To investigate the value of CT guided percutaneous treatment of pulmonary biopsy(CT-PTLB)in the diagnosis of well-defined small solitary pulmonary nodules.Methods A total of 117 cases of solitary pulmonary nodules less than 2 centimeters from January,2019 to February,2020 were analyzed respectively.Of 117 cases were divided into the benign,malignant lesions and undefinite diagnosis group according to the puncture biopsy of CT-PTLB pathologically confirmed.The relation between the incidence of complications after biopsy,the gender and age of patients,the position,the size of lesions,the distance from the lesion to the needle point,the distance from the lesions to lung pleura and the angles of the puncture were statistically evaluated.Results Among 117 patients,there were 40 benign lesions and 74 malignant lesions diagnosed.The main complications were pneumothorax and parenchymal hemorrhage and the incidence rate of them was 26.5%(31/117)and 57.3%(67/117%),respectively.The size of lesions and age of patients were determined as the important risk factors for the development of pneumothorax,the distance from the lesion to the needle point was correlated with the occurrence of pneumothorax and parenchymal hemorrhage(P<0.05),and the angle of the puncture was correlated with the occurrence of parenchymal hemorrhage(P<0.05),but there was no statistical difference in the two complications among the different pathologically confirmed group(benign,malignant lesions and undefinite diagnosis)(P>0.05).Conclusion CT-PTLB is of high value in the diagnosis of pulmonary nodules.If the related factors of complications are well controlled,it will better serve the clinical and can provide a reference for clinical diagnosis and treatment.

关 键 词：经皮穿刺肺活检 边界清晰 肺结节 诊断价值 并发症 

分 类 号：R563[医药卫生—呼吸系统]