肺部占位性病灶性质分析

Analysis on nature of lung space-occupying lesions

目的探讨分析肺部占位性病灶的临床诊断方法，明确诊断。方法回顾性分析2011年1月。2013年1月在我院收治的100例肺部占位性病灶患者的临床病例资料，分析所有患者与诊断相关的临床资料，如患者的痰涂片、支气管镜、经皮肺穿刺活检术、手术探查等，了解肺部占位性病灶的临床诊断方法，从而明确诊断。结果100例肺部占位性病灶患者中，82例患者得到确诊，诊断准确率达82．0％，22例患者经无创检查得到确诊，诊断准确率达22．0％；29例患者经支气管镜检查得到确诊，诊断准确率达29．0％；30例患者在CT引导下经皮肺穿刺活检术得到确诊，诊断准确率达30．0％；18例患者通过手术探查得到确诊，诊断准确率达18．0％。最终18例患者未得到未明确诊断，占18．0％。82例确诊的患者中包括40例肺癌，16例肺结核，14例炎性假瘤，5例平滑肌瘤，5例脂肪瘤、2例纤维瘤。结论临床上诊断病因不明确的肺部占位性病灶，诊断方法由简到难，可依次选择痰涂片、支气管镜、经皮肺穿刺活检术、手术探查等，临床诊断准确率较高。

Objective To explore and analyze the clinical diagnostic methods of lung space-occupying lesions for making a definite diagnosis. Methods The clinical data of 100 cases with lung space-occupying lesions admitted into our hospital from January 2011 to January 2013 were analyzed retrospectively. The clinical diagnosis-related data of all patients were analyzed, such as the patient＇s sputum smear, bronchoscopy, percutaneous lung biopsy, surgical exploration, etc. The clinical diagnostic methods of lung space-occupying lesions were understood then a definite diagnosis was made. Results Among 100 cases with lung space-occupying lesions, 82 patients were diagnosed and accounted for 82.0%, of which 22 patients were diagnosed by non-invasive examination and accounted for 22.0%; 29 patients were diagnosed by bronchoscopy and accounted for 29.0%; 30 patients were diagnosed by CT-guided percutaneous lung biopsy and accounted for 30.0%; 18 patients were diagnosed by surgical exploration and accounted for 18.0%. 18 patients had not been make a definite diagnosis and accounted for 18.0%. Among 82 diagnosed cases, there were 40 cases of lung cancer, 16 cases of tuberculosis, 14 cases of inflammatory pseudotumor, 5 cases of leiomyoma, 5 cases of lipoma, 2 cases of fibroma. Conclusion The clinical diagnostic methods for lung space- occupying lesions with undefined diagnostic etiology are sputum smear, bronchoscopy, percutaneous lung biopsy, surgical exploration in turn, and the accuracy of clinical diagnosis is higher.