CT引导下经皮肺穿刺切割活检的价值及安全性

The diagnostic value and security of CT-guided percutaneous transthoracic needle biopsy in patients with pneumonic diseases

目的:评价CT引导下经皮肺穿刺活检对肺部疑难疾病的诊断价值及安全性。方法:回顾性分析有手术病理、临床或影像随访结果的CT引导下经皮肺穿刺活检105例,其中97例为肺部局限性病灶(A组),8例肺部弥漫性病灶(B组)。结果:2组共有101例穿刺物结果与手术病理、临床或影像学随访结果相符,穿刺诊断正确率96.2%。A组穿刺诊断正确率(99.0%)高于B组(62.5%)(P<0.01)。A组肺癌占79.4%(77/97;B组肺癌占60.0%(3/5);二组差异无统计学意义(P>0.05)。两组合计发生气胸24例;出血34例,其中咯血18例。结论:CT引导下经皮肺穿刺切割活检穿刺诊断正确率高,是肺内疑难病变定性诊断的理想方法;使用18G穿刺针,可减少穿刺次数、降低出血的发生。

Objective：To explore the diagnostic value and complication of percutaneous CT-guided needle lung biopsy in pulmonary lesions.Methods： CT-gnided percutaneous transthoracic needle biopsy was carried out in 105 consecutive patients with pneumonic diseases who had full record of pathological, clinical or imaging fouow-up data. Results： 101 cases were matched with the results of pathology, clinic or image follow-up. The correct ratio of puncturation diagnosis was 96.2%. 80 cases of 101 were proved to be lung cancer. complications included mild pneumothorax （n = 24 ）, and small hemop tysis （n = 18）. Conclusion： CT-guided percutaneous needle biopsy in pneumonice diseases is a safe and effective diagnostic means,which has a high diagnostic rate and few complications. Its accuracy relates to the size of the targetlesion.