超声与CT引导下肺周围性病变穿刺活检术的应用价值比较研究  

Comparison of the application value of ultrasound and CT-guided puncture biopsy for peripheral lung lesions

作　　者：王泽爱 姜磊 齐凤娥 刘承平 丁宗励 陈国秀[4] WANG Ze-ai;JIANG Lei;QI Feng-e(Department of Ultrasound,The Affiliated Huai'an Hospital of Xuzhou Medical University and The Second People’s Hospital of Huai'an,Jiangsu huaian,223001,China)

机构地区：[1]徐州医科大学附属淮安医院超声医学科,江苏淮安223001 [2]新疆生产建设兵团第七师医院呼吸科,新疆伊犁833200 [3]徐州医科大学附属淮安医院呼吸科,江苏淮安223001 [4]新疆生产建设兵团第七师医院超声科,新疆伊犁833200

出　　处：《中国医学装备》2022年第10期75-78,共4页China Medical Equipment

基　　金：江苏省卫生健康委科研项目(2019-10)“缺氧微环境HIFF-1a-NRP1反馈环在非小细胞肺癌转移与EGFR-TKI耐药中的机制研究”。

摘　　要：目的:比较超声与CT引导下经皮穿刺肺活检在肺周围性病变中应用价值。方法:选取在医院行经皮肺活检的103例肺周围性病变患者,将采用超声引导穿刺活检的患者纳入超声引导组(56例),将CT引导穿刺活检的患者纳入CT引导组(47例)。以穿刺病理结果为对照,比较两组穿刺成功率、活检成功率、操作耗时、胸膜至病灶距离、与胸膜接触长度及术后并发症发生率,分析术后患者诊断满意率,并分析其临床应用价值。结果:超声引导组病型一次取材成功率为94.6%,CT引导组病理一次取材成功率为91.5%,差异无统计学意义;超声引导组患者并发症发生率为5.4%;CT引导组并发症发生率为19.2%,超声引导组并发症发生率低于CT引导组,差异有统计学意义(x^(2)=8.842,P<0.05)。超声引导组病灶直径越长、胸膜至病灶距离越短、病灶与胸膜接触长度越长则取材成功率越高,反之取材成功率越低,两者比较差异有统计学意义(x^(2)=20.649,x^(2)=21.536,x^(2)=25.354;P<0.05)。结论:超声引导与CT引导下肺周围性病变活检术均具有较高的诊断效能,而超声因具有实时动态、操作简便、无辐射、术后并发症率低等优点,可作为无骨和肺气阻挡肺周围性病变首选的穿刺引导方法。Objective: To compare the value of ultrasound and CT-guided percutaneous lung biopsy for peripheral lung lesions. Methods: 103 patients with percutaneous lung biopsy in our hospital were selected, including 56 cases of ultrasound-guided puncture and 47 cases of CT guided puncture. The success rate of puncture, the success rate of biopsy,the operation time, the distance from pleura to lesion(CM), the contact length with pleura(CM) and the incidence of postoperative complications were compared between two groups. The patient satisfaction rate after operation and its clinical application value were analyzed. Results: The success rate in one time biopsy of ultrasound-guided group was 94.6%, and that of CT guided group was 91.5%. There was no significant difference in one time success rate(P>0.05).In the ultrasound-guided group, the incidence of complication rate was 5.4%. in CT guided group, the incidence of complications was 19.2%. The incidence of complications in ultrasound guided group was significantly less than that in CT guided group, with statistical significance(x^(2)=8.842, P=0.05). In the ultrasound-guided group, the longer the diameter of the lesion, the shorter the distance between the pleura and the lesion, and the longer the contact length between the lesion and pleura, the higher the success rate of sampling, on the contrary, the lower the success rate. The difference was statistically significant(x^(2)=20.649, x^(2)=21.536, x^(2)=25.354, P<0.05). Conclusion: Both ultrasound-guided and CT-guided biopsy of peripheral lung lesions have higher diagnostic efficacy. Ultrasound can be used as the preferred puncture guide method for those without bone and lung gas to block pulmonary peripheral lesions, due to its advantages of real-time dynamic, simple operation, non-radiation and low postoperative complication rate.

关 键 词：超声引导 CT引导 肺周围性病变 穿刺肺活检 

分 类 号：R816.41[医药卫生—放射医学]