CT引导经皮肺穿刺活检对肺周围型病变的诊断价值与安全性

Diagnostic value and safety of CT-guided percutaneous puncture biopsy in diagnosis of peripheral pulmonary disease

目的评估CT引导下经皮肺穿刺活检对肺周围型病变的诊断价值与安全性。方法肺周围型病变的177例住院患者,胸部CT检查均发现肺周围型病变,气管镜检查均大致正常。所有患者均行CT引导下经皮肺穿刺活检,采用组织细胞学方法检测,必要时联合免疫组织化学检测以进一步完善诊断。结果 177例肺周围性肿块均穿刺成功,其中168例取得了明确的病理诊断结果:肺癌109例,肺结核21例,慢性炎症37例,韦格纳肉芽肿1例。气胸发生率为8.5%,咯血发生率为6.8%,经治疗后并发症好转,病情稳定。结论 CT引导下肺穿刺活检对肺周围病变定性诊断的准确性较高、安全可靠。

Objective To evaluate the security and value of CT-guided percutaneous puncture biopsy in the diagnosis of peripheral pulmonary disease. Methods One hundred and seventy-seven patients with peripheral pulmonary disease diagnosed by CT scanning, and with a normal result under fibro-bronchoscopy, were enrolled in the study. Patients were performed with CT-guided percutaneous puncture biopsy and cytological analysis, and combined with immunohistochemical analysis if necessary for further diagnosis.Results All 177 patients successfully underwent biopsy, in which 168 cases were pathologically definitive diagnosed： 109 cases were bronchogenic carcinoma, 21 cases were pulmonary tuberculosis, 37 cases were chronic inflammation. After the biopsy, 8.5% of the patients got a pneumothorax, and 6.7% got a hemoptysis, which were improved and stable after treatment.Conclusion CT-guided percutaneous puncture biopsy is high-valued and safe in the diagnosis of peripheral pulmonary disease.