超声造影在周围型肺病变诊断及穿刺活检中的作用分析  

Analysis of the role of contrast-enhanced ultrasound in the diagnosis of peripheral pulmonary lesions and puncture biopsy

作　　者：许宇光[1] 周广新[1] 杨坤[1] 杨颖初[1] 郑智文 姚亚辉 刘晓真[1] XU Yuguang;ZHOU Guangxin;YANG Kun;YANG Yingchu;ZHENG Zhiwen;YAO Yahui;LIU Xiaozhen(Department of Ultrasound Imaging,Zhongshan City People's Hospital,Guangdong Province,Zhongshan 528403,China)

机构地区：[1]广东省中山市人民医院超声影像科,广东中山528403

出　　处：《中国当代医药》2024年第25期91-95,共5页China Modern Medicine

基　　金：广东省中山市社会公益科技研究项目(2022B1118)。

摘　　要：目的探讨超声造影在周围型肺病变诊断和穿刺活检中的作用。方法选取2018年1月至2021年5月中山市人民医院收治的120例周围型肺病变患者作为研究对象,按照随机数字表法分为对照组与观察组,每组60例。对照组在常规超声引导下进行穿刺活检,观察组在超声造影引导下进行穿刺活检。比较两组患者的穿刺成功率、穿刺时间、并发症发生率、生命体征指标、疼痛评分、舒适度评分。诊断金标准为手术病理诊断结果,比较常规超声和超声造影引导下穿刺活检诊断周围型肺癌的价值,并分析两种穿刺活检诊断结果与手术病理诊断结果之间的一致性。结果观察组的一次穿刺成功率高于对照组,但穿刺时间短于对照组,且穿刺操作相关并发症总发生率低于对照组,差异有统计学意义(P<0.05)。两组患者穿刺时与穿刺前的收缩压、舒张压以及心率组间和组内比较,差异无统计学意义(P>0.05)。两组患者在穿刺后10 min的疼痛程度均低于本组穿刺时,舒适度评分均高于本组穿刺时,差异有统计学意义(P<0.05);两组患者穿刺时和穿刺后疼痛评分、舒适度评分组间比较,差异无统计学意义(P>0.05)。超声造影引导的穿刺活检的灵敏度、特异度、准确率、阳性预测值、阴性预测值高于常规超声引导,差异有统计学意义(P<0.05)。两种穿刺活检的诊断结果与手术病理诊断结果均一致,前者一致性较高,后者一致性中等。结论超声造影在周围肺病变患者穿刺活检中可起到良好的引导作用,有效提高穿刺成功率,减少并发症,且超声造影引导下穿刺活检对周围型肺癌具有良好的诊断作用。Objective To investigate the role of contrast-enhanced ultrasound in the diagnosis of peripheral pulmonary disease and puncture biopsy.Methods A total of 120 patients with peripheral pulmonary disease admitted to Zhongshan City People's Hospital from January 2018 to May 2021 were selected as research objects,and they were divided into control group and observation group according to random number table method,with 60 cases in each group.The control group underwent puncture biopsy under the guidance of conventional ultrasound,and the observation group underwent puncture biopsy under the guidance of contrast-enhanced ultrasound.The puncture success rate,puncture time,complication rate,vital signs index,pain score and comfort score of the two groups were compared.The gold standard for diagnosis was surgical pathological diagnosis.The value of conventional ultrasound and contrast-enhanced ultrasound guided needle biopsy in the diagnosis of peripheral lung cancer was compared,and the consistency between the two kinds of needle biopsy diagnosis and surgical pathological diagnosis were analyzed.Results The success rate of one-off puncture in observation group was higher than that in control group,but the puncture time was shorter than that in control group,and the total incidence of complications related to puncture operation was lower than that in control group,the differences were statistically significant(P<0.05).There were no significant differences between the two groups in systolic blood pressure,diastolic blood pressure and heart rate before puncture(P>0.05).The pain degrees in two groups at 10 min after puncture were lower than those during puncture,and the comfort scores were higher than those during puncture,the differences were statistically significant(P<0.05).There were no significant differences in pain score and comfort level between the two groups during and after puncture(P>0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of biopsy guided by contrast-enh

关 键 词：周围型肺癌 超声造影 诊断 穿刺活检 并发症 

分 类 号：R734.2[医药卫生—肿瘤]