CT引导下经皮肺穿刺活检(附2015例分析)

CT-guided percutaneous transthoracic aspiration biopsy of lung lesions

目的探讨CT引导下经皮肺穿刺活检术在肺部肿块(结节)病灶的诊断价值。方法回顾性分析2015例CT引导下经皮肺穿刺活检术的临床资料,使用抽吸针、自制螺旋槽式穿刺活检针、Cook-18G切割活检针穿刺活检,总结穿刺操作经验,评价临床效果,讨论其并发症及处理方法。结果本组2015例患者2153个病灶作了2269次穿刺。其中,良性病变诊断准确率82.9%(662/799),恶性病变诊断准确率96.4%(1172/1216),总的准确性为91.0%(1834/2015)。气胸发生率7.2%(146/2015),咯血发生率6.6%(132/2015)。结论自制螺旋槽式穿刺活检针与Cook-18G切割活检针选择使用,能提高穿刺活检阳性率及组织学诊断正确率,且并发症发生率低,有较高的推广应用价值。

Objective To analyze CT-guided percutaneous transthoracic aspiration biopsy in diagnosis of lung lesions（mass/nodule）. Methods Clinical date of 2015 patients performed with CT-guided percutaneous transthoracic aspiration biopsy of lung lesions was reviewed. Fine needle, self- restraint spiral groove type needle and Cook-18G cutting needle were used. Puncture operation experience was summarized. Clinical effect was assessed; reasons and treatment of complications were discussed. Results 662 lesions were diagnosed as benign and 1172 lesions as malignant. The accuracy of CT- guided biopsy was 91.0% （1834/2015） .Univariant analysis showed that the diagnostic accuracies for benign and malignant lesions were 82.9% （662/799） and 96.4% （1172/1216）, pneumothorax occurred in 7.2% （146/2015）, and hemoptysis occurred in 6.6% （132/2015）.Conclusion The self-restraint spiral groove type needle and Cook-18G cutting needle were coordinate used that can be improved positive rate of needle biopsy and accuracy of histology diagnosis, and it has been proved to be an effective and safe means and should be popularized.