CT引导下经皮肺穿刺与经支气管镜透壁肺活检对无反应性肺炎的诊断价值  

CT-guided percutaneous lung puncture biopsy versus bronchoscopic penetrating mural lung biopsy in the diagnosis of no-reactive pneumonia

作　　者：蒲德利 何艳 潘晓杰 潘自贤 刘宇峰 陈雪英 PU Deli;HE Yan;PAN Xiaojie;PAN Zixian;LIU Yufeng;CHEN Xueying(Department of Respiratory Medicine,Guiyang Municipal Second People’s Hospital,Guiyang,Guizhou Province 550000,China)

机构地区：[1]贵阳市第二人民医院呼吸科,贵州贵阳550000

出　　处：《介入放射学杂志》2023年第7期676-679,共4页Journal of Interventional Radiology

基　　金：2020年贵州省卫生健康委科学技术基金项目(gzwjkj2020-1-056)。

摘　　要：目的 比较CT引导下经皮肺穿刺和经支气管透壁镜肺活检对无反应性肺炎的诊断价值。方法 选取2020年4月至2022年5月贵阳市第二人民医院收治的无反应性肺炎患者51例,按照随机数字表随机分为观察组26例,对照组25例。观察组患者行CT引导下经皮肺穿刺,获取的肺组织部分经革兰染色及抗酸染色后涂片,部分进行培养及病理检查。对照组患者先行常规支气管镜检查,获取的肺泡灌洗液经革兰染色及抗酸染色后涂片及培养;再行经支气管镜透壁肺活检,获取的肺组织处理与观察组相同。比较两组患者肺组织标本中病原阳性检出率及并发症的发生率。结果 观察组阳性检出率为80.77%(21/26),对照组阳性检出率为56.00%(14/25),差异有统计学意义(P<0.05)。观察组并发症的发生率为38.46%(10/26),其中气胸6例,出血4例(肺内出血3例,痰血1例);对照组并发症的发生率为36.00%(9/25),其中气胸3例,出血6例(肺内出血1例,痰血4例,咯血1例),差异无统计学意义(P>0.05)。并发症经对症处理后均好转。结论 无反应性肺炎患者行CT引导下经皮肺穿刺活检的病原阳性检出率高于经支气管镜透壁肺活检,而并发症相当,无严重不良反应。Objective To compare the clinical value of CT-guided percutaneous lung puncture biopsy with that of bronchoscopic penetrating mural lung biopsy in diagnosing no-reactive pneumonia.Methods A total of 51 patients with no -reactive pneumonia, who were admitted to the Guiyang Municipal Second People’sHospital of China between April 2020 and May 2022, were selected. By using random number table method, thepatients were randomly divided into the observation group(n=26) and the control group(n=25). The patientsin the observation group underwent CT- guided percutaneous lung puncture biopsy. The smears of the obtainedlung tissues were stained with gram staining and acid resistance staining, and some tissues were cultured andpathologically examined. The patients in the control group underwent routine bronchoscopy, and the smears ofthe obtained alveolar lavage fluid were stained with gram staining and acid resistance staining. Then,bronchoscopic penetrating mural lung biopsy was performed, the obtained lung tissue was processed in thesame way as in the observation group. The pathogen-positive detection rate and the incidence of complicationswere compared between the two groups. Results The pathogen-positive detection rate in the observation groupwas 80.77%(21/26), which in the control group was 56.00%(14/25), and the difference between the two groupswas statistically significant(P<0.05). The incidence of complications in the observation group was 38.46%(10/26),including pneumothorax(n=6), intrapulmonary hemorrhage(n=3) and bloody sputum(n=1);the incidence ofcomplications in the control group was 36.00%(9/25),including pneumothorax (n=3), intrapulmonary hemorrhage(n=1), bloody sputum(n=1) and hemoptysis(n=1). No statistically significant difference in the incidence ofcomplications existed between the two groups(P>0.05). All the complications were improved after symptomatictreatment. Conclusion The pathogen-positive detection rate of CT-guided percutaneous lung puncture biopsyis higher than that of bronchoscopic penetrating

关 键 词：计算机断层扫描术 经皮肺穿刺 经支气管镜肺活检 无反应性肺炎 诊断 

分 类 号：R563.1[医药卫生—呼吸系统]