CT引导下经皮肺穿刺活检术在肺部占位性病变诊断中的临床应用  

Analysis of the clinical application of CT-guided percutaneous lung biopsy in the diagnosis of pulmonary space-occupying lesions

作　　者：凤婧[1] 颜浩[1] 韩娟[1] 解梅 罗凤鸣[2] FENG Jing;YAN Hao;HAN Juan;XIE Mei;LUO Fengming(Department of Respiratory and Critical Care Medicine,Chengdu Second People′s Hospital,Chengdu,Sichuan 610017,China;Department of Respiratory and Critical Care Medicine,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China)

机构地区：[1]成都市第二人民医院呼吸与危重症医学科,成都610017 [2]四川大学华西医院呼吸与危重症医学科,成都610041

出　　处：《重庆医学》2022年第4期607-611,617,共6页Chongqing medicine

基　　金：四川省卫生健康适宜技术推广项目(20SYJS24);四川省医学会(恒瑞)科研基金专项科研课题(2021HR12)。

摘　　要：目的探讨CT引导下经皮肺穿刺活检(CT-PTNB)术在肺部占位性病变中的应用价值。方法收集2018年1月至2020年5月于成都市第二人民医院行CT-PTNB术的121例肺部占位性病变患者的临床和病理资料,回顾性分析患者病理类型,计算穿刺成功率,并分析CT-PTNB术后并发症发生情况及其影响因素。结果患者穿刺成功率为97.52%,其中108例(91.52%)患者通过穿刺确诊;术后并发症发生率为34.74%,主要为气胸与出血,其中气胸发生率为20.34%,出血发生率为13.56%;患者年龄、性别、体重指数、吸烟史、基础疾病史、病灶位置(上/中叶或下叶)及病理结果与气胸、出血的发生无关(P>0.05);并发气胸或出血的患者病灶平均直径较未并发气胸或出血者小(t=5.296、4.723,P<0.05),病灶与胸壁距离较未并发气胸或出血者大(t=4.877、4.225,P<0.05)。结论CT-PTNB术在肺部占位性病变诊断中的确诊率高,主要并发症为气胸及出血,均与病灶平均直径及病变与胸壁间距离有关。Objective To investigate the application value of CT-guided percutaneous lung biopsy(CT-PTNB)in the diagnosis of pulmonary space-occupying lesions.Methods The clinical and pathological data of 121 patients with pulmonary space-occupying lesions who underwent CT-PTNB in the Chengdu Second People′s Hospital from January 2018 to May 2020 were collected.The pathological types of the patients were analyzed retrospectively,the success rate of puncture was calculated,and the complications after CT-PTNB and its influencing factors were analyzed.Results The success rate of puncture was 97.52%,of which 108 cases(91.52%)were diagnosed by puncture.The incidence of postoperative complications was 34.74%,mainly pneumothorax(20.34%)and hemorrhage(13.56%).The patients′ages,gender,body mass index(BMI),smoking history,underlying diseases,lesion location(lung upper/middle lobe or lower lobe)and pathological diagnosis were not associated with the occurrence of pneumothorax and hemorrhage(P>0.05).Furthermore,the mean diameter of lesions in patients complicated with pneumothorax or bleeding was smaller than that in patients without pneumothorax or bleeding(t=5.296,4.723,P<0.05),and the distance between lesions and chest wall was larger than that in patients without pneumothorax or bleeding(t=4.877,4.225,P<0.05).Conclusion The CT-PTNB has a high correct diagnosis rate of pulmonary space-occupying lesions.The main complications are pneumothorax and hemorrhage,which are related to the average diameter of the lesion and the distance between the lesion and the chest wall.

关 键 词：计算机断层扫描术 肺 活体组织检查 并发症 影响因素 

分 类 号：R655.3[医药卫生—外科学]