五种活检术在肺部块影诊断中的对比研究

The diagnostic value of 5 methods biopsy and comparative study in lung mass

目的:探讨五种活检方法在肺部块影诊断中的价值。方法:选择门诊及住院患者经肺部平片及/或CT检查结果诊断为肺部块影1 180例,应用经纤支镜肺活检,X线引导下、B超引导下、CT引导下肺穿刺活检及开胸肺活检术进行检查,并对有关资料进行分析研究。结果:对中央型肺部块影应用CT引导下肺活检诊断阳性率显著高于纤支镜检查及X线引导下肺活检组(P<0.05)。纤支镜活检阳性率显著高于X线引导下肺活检组(P<0.05);对周围型肺部块影应用CT引导下肺活检阳性率显著高于纤支镜活检、X线及B超引导下肺活检组(P<0.05)。X线引导下肺活检阳性率显著高于纤支镜检查组(P<0.05)。开胸肺活检诊断阳性检率为100%。结论:应用纤支镜肺活检对中央型肺部块影诊断阳性率较高、费用低、并发症少,易作为首选检查;对于周围型肺部块影应用CT引导下穿刺肺活检阳性率高、并发症少,宜作为首选检查。开胸肺活检创伤大,费用高,患者不易接受,故可在其它方法不能确诊情况下选用。

Objective：To explore the diagnostic value of the lung mass by 5methods of the biopsy. Methods：using fibrobonchoscopic （FB） ,x -ray, CT ,ultrasonic guided and Open chest lung biopsy examination for 1180 patients in outpatients and hospital ization and analyzing the results of the biopsy. Results ： The positive rate of the CT guided lung biopsy is more higher than that of FB and x - ray examination significantly for central lung mass （ P 〈 O. 05 ）. The positive rate of the CT guided lung biopsy is more higher than that of the FB ,x - ray and ultrasonic examination significantly for peripheral lung mass（ P 〈 0. 05 ）. The positive rate of x - ray guided lung biopsy is higher than that of FB examination in peripheral lung mass （ P 〈 0. 05 ） , The positive rate of open chest lung biopsy is 100%. Conclusions： Using FB lung biopsy should be the first means for central lung mass because of the higher positive rate ,lower cost and complications . CT guided lung biopsy can be the first means for the peripheral lung mass because of the higher positive rate and lower complication. The positive rate of open chest lung biopsy is highest, but its complication and cost were higher than the others, so it can be considered once the other method couldnt be diagnosis clearly.