超声引导下穿刺活检术对肺周围型肿块取材的影响因素分析  

Analysis of the influencing factors of ultrasound-guided puncture biopsy on the sampling of peripulmonary mass

作　　者：毕方平 刘蕊 李卫群[1] 朱彪[1] BI Fangping;LIU Rui;LI Weiqun;ZHU Biao(Department of Ultrasonic diagnosis,Inpatient Department,Loudi Central Hospital,Hunan,Loudi 417000,China)

机构地区：[1]娄底市中心医院住院部超声诊断科,湖南娄底417000

出　　处：《中国现代医生》2022年第26期10-13,共4页China Modern Doctor

基　　金：湖南省科技创新计划项目(2020SK51603)。

摘　　要：目的探讨超声引导下穿刺活检术对肺周围型肿块取材的影响因素。方法选取2019年1月至2021年10月在娄底市中心医院经CT诊断为肺周围性肿块的住院患者共93例,根据肿块大小的不同,分为<3cm组(n=21)、3~6m组(n=31)、>6cm组(n=41);根据穿刺针型号的不同,分为FNA组(n=14)与CNB组(n=79);根据超声造影的结果,分为局部坏死组(n=42)与无坏死组(n=51)。所有患者术前均行超声造影,造影结束后行超声引导下肺穿刺活检术。比较不同肿块直径(<3cm、3~6cm、>6cm)、不同穿刺针型号(16G、18G)、病灶内部有无坏死(有坏死、无坏死)患者之间取材成功率、并发症方面的差异。结果93例患者中,原发性肺癌51例,慢性肺炎28例,并发症14例,其中取材失败12例。51例原发性肺癌中,腺癌37例,鳞癌13例,小细胞癌1例。比较FNA组与CNB组并发症发生率,差异无统计学意义(P>0.05);CNB组取材成功率明显高于FNA组,差异有统计学意义(P<0.05)。不同肿块直径患者的并发症发生率比较,差异无统计学意义(P>0.05);不同肿块直径患者的取材成功率比较,差异有统计学意义(P<0.05);无坏死组并发症发生率低于有坏死组,差异有统计学意义(P<0.05),两组取材成功率比较,差异无统计学意义(P>0.05)。结论超声引导下肺穿刺活检术是肺周围型肿块的主要取材方式,取材成功率高,并发症低。穿刺针型号、肿块直径是肺周围型肿块取材的影响因素。Objective To investigate the influence factors of ultrasound-guided puncture biopsy on the sampling of peripulmonary mass.Methods A total of 93 inpatients with peripulmonary mass diagnosed by CT in Loudi Central Hospital from January 2019 to October 2021 were selected.According to the different tumor size,they were divided into group<3cm(n=21),group 3~6cm(n=31)and group>6cm(n=41).According to different puncture needle types,they were divided into FNA group(n=14)and CNB group(n=79).According to the results of contrast-enhanced ultrasound,they were divided into local necrosis group(n=42)and non-necrosis group(n=51).All patients received contrast-enhanced ultrasound before surgery,and ultrasound-guided lung puncture biopsy was performed after the angiography.The differences in sampling success rate and complications among patients with different tumor sizes(<3cm,3-6cm,>6cm),different puncture needle types(16G,18G),and with or without necrosis in the lesion were compared.Results Among the 93 patients,51 cases were primary lung cancer,28 cases were chronic pneumonia,14 cases had complications,and 12 cases were failed in sampling.Among the 51 primary lung cancers,37 cases were adenocarcinoma,13 cases were squamous cell carcinoma,and 1 case was small cell carcinoma.Compared with the FNA group,there was no statistical difference in the incidence of complications in CNB groups,the difference was not statistically significant(P>0.05),but the sampling success rate of the CNB group was significantly higher than that of the FNA group,the difference was statistically significant(P<0.05).No statistically significant difference in the incidence of complications when comparing patients with different mass diameters(P>0.05);statistically significant difference in the success rate of retrieval when comparing patients with different mass diameters(P<0.05).Compared with the group with necrosis,the complication rate of the group without necrosis was lower(P<0.05),and the sampling success rate was slightly higher,but the difference was

关 键 词：超声引导 经皮穿刺活检 肺周围型肿块 超声造影 

分 类 号：R734.2[医药卫生—肿瘤]