两种组织活检术在肺部块影鉴别诊断中的对比性分析

The comparative analysis of two types of lung biopsy for the differential diagnosis of lung mass shadow

目的对比分析经纤维支气管镜(下称纤支镜)活检和CT引导下经皮肺穿刺活检在肺部块影鉴别诊断中的临床价值。方法符合研究的144例肺部块影患者,按CT检查影像学特点将病人分为中央型和周围型两组,病例分别接受纤支镜和CT引导下经皮肺穿刺肺组织活检,继后送病理学检查。对比两种组织活检方法的阳性率及并发症。结果中央型块影患者纤支镜检查阳性率为94.7%,CT引导下经皮肺穿刺活检阳性率20%;周围型块影患者纤支镜检查阳性率为60%,CT引导下经皮肺穿刺活检阳性率为92.8%。结论在肺部块影的鉴别诊断方法中,对于中央型患者宜首选纤支镜活检,而对于周围型患者宜选用CT引导下经皮肺穿刺活检。

Objective To comparing analyse the clinical value of bronchoscopy lung biospsy and lung puncture biopsy through skin under CT guidance for the differential diagnosis of lung mass shadow.Methods selected 144 cases with lung mass shadow which met the study standard, and divided into central type groups and peripheral type groups according to their imaging character, all cases were treated with bronchoscopy lung biopsy or lung puncture biopsy through skin under CTguidance, and then the samples were sent for pathological examination. At the end, compared the positive rate and complecations of the two types of lung biopsy.Results The positive rate of bronchoscopy lung biopsy is94.7% in central mass shadowwhile the positive rate of lung puncture biopsy through skin under CT guidance is 20%; at the same time, the positive rate of the former is60% in peripheral mass shadowpatients while the positive rate is 92.8% of the latter.Conclusions For the differential diagnosis of lung mass shadow, the brochoscopy test should be selected at first to the central type and lung puncture biopsy through skin under CTguidance to the peripheral type.