对比CT引导下以半自动与全自动活检针行经皮肺穿刺活检的有效性及安全性  

Efficacy and safety of CT-guided percutaneous lung biopsy using semi-automatic or automatic biopsy needle

作　　者：马盛梅 贾海鹏[1] 孙大千 高敏[2] 孟红[1] 李春海[1] MA Shengmei;JIA Haipeng;SUN Daqian;GAO Min;MENG Hong;LI Chunhai(Department of Radiology,Qilu Hospital of Shandong University,Jinan 250012,China;School of Nursing and Rehabilitation,Shandong University,Jinan 250012,China)

机构地区：[1]山东大学齐鲁医院放射科,山东济南250012 [2]山东大学护理与康复学院,山东济南250012

出　　处：《中国介入影像与治疗学》2023年第6期330-334,共5页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的对比观察CT引导下以半自动活检针(SAB)与全自动活检针(AB)行经皮肺穿刺活检的价值及安全性。方法纳入328例接受CT引导下经皮肺穿刺活检的肺病变患者,根据所用活检针分为SAB组(n=151)及AB组(n=177);比较组间可操作性、诊断效能和并发症的差异,采用logistic回归分析评估影响高级别肺出血的独立影响因子。结果2组穿刺成功率均为100%。AB组可操作评价结果均优于SAB组(P均<0.05)。2组诊断特异度和阳性预测值均为100%;SAB组诊断敏感度91.00%、准确率94.04%、阴性预测值85.00%,AB组分别95.52%、96.61%及87.76%,组间差异均无统计学意义(P均>0.05)。2组气胸发生率差异无统计学意义(P>0.05),肺出血及高级别出血率差异均有统计学意义(P均<0.05)。病灶大小、与胸膜距离及活检针类型是高级别肺出血的独立影响因子(OR=0.95、1.06、2.61,P均<0.05)。结论CT引导下以SAB或AB行经皮肺穿刺活检均安全、有效;以AB活检临床可操作性更强,而以SAB活检肺出血发生率更低。Objective To comparatively observe the value and safety of CT-guided percutaneous lung biopsy using semi-automated biopsy(SAB)or automated biopsy(AB)needles.Methods Totally 328 patients with lung lesions who underwent CT-guided percutaneous lung biopsy were divided into SAB group(n=151)and AB group(n=177)according to the type of biopsy needle.The operability,diagnostic efficacy and complications were compared between groups,then logistic regression analysis was used to screen independent impact factors of high-grade pulmonary hemorrhage after biopsy.Results The success rate of puncture was 100%in both groups,and the operational evaluation results of AB group were better than those of SAB group(all P<0.05).The specificity and positive predictive value of the two groups were both 100%.The diagnostic sensitivity,accuracy and the negative predictive value of SAB group was 91.00%,94.04%and 85.00%,respectively,while of AB group was 95.52%,96.61%and 87.76%,respectively(all P>0.05).No significant difference of the incidence of pneumothorax was found between groups(P>0.05),while significant differences of the rates of pulmonary hemorrhage and high-grade hemorrhage existed between groups(both P<0.05).Lesion size,subpleural location and biopsy needle type were independent impact factors of high-grade pulmonary hemorrhage(OR=0.95,1.06,2.61,all P<0.05).Conclusion CT-guided percutaneous lung biopsy using SAB or AB were both effective and safe.AB was more clinically operable,and SAB had lower incidence of pulmonary hemorrhage.

关 键 词：肺肿瘤 穿刺术 活组织检查 体层摄影术 X线计算机 

分 类 号：R734.2[医药卫生—肿瘤] R815[医药卫生—临床医学]