多层螺旋CT引导活检肺部结节的临床应用价值  

Value of multilayer spiral CT-guided biopsy of pulmonary nodules for clinical applications

作　　者：韩莉[1] 高航[2] HAN Li;GAO Hang(CT Room,Tengzhou Workers'Hospital,Tengzhou,Shandong 277500,China;Jining the Second Peoples Hospital,Jining,Shandong 272000,China)

机构地区：[1]滕州市工人医院CT室,山东滕州277500 [2]济宁市第二人民医院医学影像科,山东济宁272000

出　　处：《医药论坛杂志》2023年第17期108-112,F0003,共6页Journal of Medical Forum

摘　　要：目的探讨多层螺旋CT引导下经胸活检不同大小肺部结节的临床应用价值。方法2017年4月—2022年5月在滕州市工人医院行多层螺旋CT引导下经胸肺活检的83例肺结节患者资料,按肺结节直径分为小结节组(n=13)、中结节组(n=37)和大结节组(n=33)。比较穿刺活检结果和最终诊断结果,采用单因素分析比较患者并发症发生率,采用logistic多因素回归分析分析肺结节穿刺患者气胸和肺出血的独立危险因素。结果小结节组诊断准确率、敏感性、特异性分别为92.31%、100.00%、88.89%,中结节组诊断准确率、敏感性和特异性分别为94.59%、100.00%和89.47%,大结节组诊断准确率、敏感性和特异性分别为93.94%、100.00%和60.00%。小结节组肺出血发生率高于中结节组和大结节组,差异有统计学意义(F=10.26,P<0.05);3组并发症总发生率比较差异无统计学意义(F=0.65,P>0.05)。单因素分析显示发生气胸的患者与穿刺针长度、穿刺位置和穿刺针穿过肺组织的长度比较差异均有统计学意义(均P<0.05);发生肺出血的患者在穿刺时间、针道长度、穿刺针穿过肺组织的长度方面存在统计学意义差异(P<0.05)。logistic多因素分析显示针长>50 mm、侧卧位和穿刺针穿过肺组织≥14 mm的距离是肺部结节穿刺活检后气胸的独立危险因素(P<0.05);穿刺时间≥15 min、针道长度>50 mm、穿刺针穿过肺组织的距离≥14 mm肺部结节穿刺活检后肺出血的独立危险因素(P<0.05)。结论多层螺旋CT引导下经胸肺活检可有效诊断不同大小的肺结节。Objective To explore the clinical application of multilayer spiral CT-guided transthoracic biopsy of lung nodules of different sizes.Methods The data of 83 patients with pulmonary nodules who underwent multilayer spiral CT-guided transthoracic lung biopsy at Tengzhou Workers Hospital from April 2017 to May 2022 were divided into small nodule group(n=13),medium nodule group(n=37)and large nodule group(n=33)according to the diameter of pulmonary nodules.The results of puncture biopsy and final diagnosis were compared,and the incidence of complications in patients was compared using univariate analysis and independent risk factors for pneumothorax and pulmonary haemorrhage in patients with pulmonary nodule puncture were analysed using logistic multi-factor regression analysis.Results The diagnostic accuracy,sensitivity and specificity were 92.31%,100.00%and 88.89%in the small nodule group,94.59%,100.00%and 89.47%in the medium nodule group and 93.94%,100.00%and 60.00%in the large nodule group,respectively.The incidence of pulmonary haemorrhage was higher in the small nodule group than that in the medium and large nodule groups,with a statistically significant difference(F=10.26,P<0.05);the difference in the overall incidence of complications was not statistically significant when comparing the three groups(F=0.65,P>0.05).Univariate analysis showed statistically significant differences in patients who developed pneumothorax compared to puncture needle length,puncture location and length of puncture needle through lung tissue(all P<0.05).logistic multifactorial analysis showed that needle length>50 mm,lateral position and distance of the needle through the lung tissue≥14 mm were independent risk factors for pneumothorax after lung nodule aspiration biopsy(P<0.05);puncture time≥15 min,needle tract length>50 mm and distance of the needle through the lung tissue≥14 mm were independent risk factors for pneumothorax after lung nodule aspiration biopsy(P<0.05).Length of puncture>50 mm and distance of the puncture needl

关 键 词：多层螺旋CT 活检诊断 肺部结节 临床应用 

分 类 号：R814.42[医药卫生—影像医学与核医学]