超声引导下经皮肺和胸膜穿刺活检的应用

Ultrasound guided percutaneous automatic biopsy of pulmonary and pleural disease

目的探讨超声引导下经皮肺、胸膜穿刺活检的组织学诊断准确性和并发症。方法对120例外周型肺占位和胸膜病变进行超声引导下的穿刺活检。结果120例患者均成功取材。病理结果示腺癌34例,鳞癌40例,低分化癌14例,小细胞癌4例,恶性间皮瘤4例,间皮瘤6例,结核病变4例,炎性病变12例,隔离肺2例。其中3例假阴性,活检结果为炎性病变,手术后病理结果示鳞癌。气胸7例,未经治疗自愈,咯血1例,其它112例均未出现明显并发症。结论超声引导下对外周肺、胸膜病变活检,具有准确性高、并发症少的特点,对临床诊疗具有重要的价值。

Objective To study the accuracy and complication of ultrasound guided percutaneous automatic biopsy of puhnonary and pleural disease. Methods Sixty patients with peripheral hmg cancer and pleural diseases were performed the ultrasound guided percutaneous automatic biopsy with 18 Gange needle （Bard Company, US） and Acuson Seqia 512 sonograph. Results All 120 patients were performed the ultrasound guided percutaneous automatic biopsy successfully. Thirty- four cases with adenocarcinoma, 40 cases with squamous cell carcinoma, 7 cases with poorly differentiated carcinoma, 4 cases with small cell carcinoma, 4 cases with malignant mesothelioma, 6 cases with mesothelioma,4 cases with tuberculosis, 12 cases with inflammation disease and 2 case with pulmonary sequestration were proved by pathology. There was only 3 cases with false negtive diagnosis that a squamous cell carcinoma was made a wrong diagnosis as inflammation disease. In all 120 patients, there were 7 cases with pneumothorax and 1 cases with haemoptysis which did not received any more special treatment. Conclusion Ultrasound guided automatic percutaneous biopsy has good value in diagnosis of the peripheral lung cancer and pleural disease because of high accuracy and low complication.