CT导向下胸膜穿刺活检在结核性胸膜炎诊断中的价值  

Value of computed tomography-guided pleural biopsy in the diagnosis of tuberculous pleurisy

作　　者：姜利梅 刘彩荣 朱有全 Jiang Limei;Liu Cairong;Zhu Youquan(Department of Imaging,Zhecheng Hospital of Traditional Chinese MedicineHenan 476200,China;Depart-ment of Respiratory Medicine,Zhecheng Hospital of Traditional Chinese Medicine,Henan 476200,China;Department of Thoracic Surgery,Zhecheng Hospital of Traditional Chinese Medicine,Henan 476200,China)

机构地区：[1]河南省柘城中医院影像科,476200 [2]河南省柘城中医院呼吸内科,476200 [3]河南省柘城中医院胸外科,476200

出　　处：《实用医技杂志》2022年第5期464-467,共4页Journal of Practical Medical Techniques

摘　　要：目的探讨CT导向下胸膜穿刺活检在结核性胸膜炎诊断中的价值。方法选择柘城中医院2019年6月至2020年10月住院治疗的83例经皮胸膜穿刺活检患者,完成细胞学检查、组织学检查,并采集胸腔积液,其中7例患者无胸腔积液,76例患者完成胸腔积液常规检查、生化检查、细胞学检查、病原性检查。记录CT导向下胸膜穿刺活检与胸腔积液检测结果的阳性率、CT导向下胸膜穿刺活检的并发症发生情况。结果CT导向下胸膜穿刺活检诊断结核性胸膜炎的阳性率(56/83,67%)高于胸腔积液检测(32/76,42%),诊断总阳性率(67/83,81%)高于胸腔积液检测(44/76,58%)(P<0.05),其中有4例患者出现肺部出血,3例患者出现气胸,6例患者出现气急、咳嗽,并发症总发生率为16%。结论CT导向下胸膜穿刺活检可提高结核性胸膜炎诊断的阳性率,且安全性高。Objective To explore the value of computed tomography(CT)-guided pleural biopsy in the diagnosis of tuberculous pleurisy.Methods A Total of 83 patients with percutaneous pleural biopsy were selected who were hospitalized in our hospital between June 2019 and October 2020,and underwent complete cytological and histological examinations,and from whom we collected pleural effusion samples.Among these patients,seven had no pleural effusion,and 76 completed routine pleural fluid,biochemical,cytology,and pathogenicity examinations.Positivity rates of CT-guided pleural biopsy and pleural fluid test results were re-corded,as well as the occurrence of complications of CT-guided pleural biopsy.Results The positivity rate for the diagnosis of tuberculous pleurisy and the total positive rate of diagnosis of CT-guided pleural biopsy were higher than those for the pleural effusion test(67%vs 42%and 81%vs 58%,respectively,P<0.05).Four patients had pleural effusion.Pulmonary bleeding and pneumothorax occurred in three patients,shortness of breath and cough occurred in six patients,and the overall complication rate was 16%.Conclusion CT-guided pleural biopsy is safe and increased the positivity rate for the diagnosis of tuberculous pleurisy.

关 键 词：体层摄影术 螺旋计算机 胸膜 穿刺 活检 结核 胸膜 诊断 

分 类 号：R521.7[医药卫生—内科学] R816.4[医药卫生—临床医学]