肺周围性病变CT下经支气管和经皮活检的应用

The application of the transbronchial and percutaneous biopsy guided by computer tomography in pulmonary peripheral lesions

目的评价 CT引导纤维支气管镜经支气管肺活检 (CT-TBLB)和经皮肺穿刺活检 (CT-NL B)在肺周围性病变中的综合应用价值。方法根据病灶处在肺野位置不同 ,5 1例选择 CT-TBL B,46例采用 CT-NL B。结果综合选择下两组肺活检取材总成功率达 10 0 % ,阳性率 87.6% ,诊断符合率 97.9% (其中 CT-TBLB达 10 0 % ) ,气胸和咯血等并发症明显较少。两种方法阳性率和符合率较高 ,但组间无显著性差异 (P均 >0 .0 5 )。结论 CT-TBLB和 CT-NL B是肺周围性病变定性诊断可行的和理想的非开胸活检方法 ,适合不同位置类型病灶。若综合选用可提高肺周围活检的准确性和安全性。

Objective To evaluate the comprehensive application of the CT guided transbronchial lung biopsy (CT TBLB) and CT guided percutaneous needle lung biopsy (CT_NLB) in pulmonary peripheral lesions.Methods According to the lesion location in lung field,51 patients were selected to CT TBLB and 46 patients to CT NLB.Results In the comprehensive application of the two lung biopsy methods,the comphensive biopsy success rate was 100%,pathological diagnostic positive rate 87.6% and diagnostic correct rate 97.9% (of them 100% in CT TBLB).The complications of pneumothorax and haemoptysis were decreased significantly.The positive rate and diagnostic correct rate seem higher,but there was no significant difference between the two methods (P<0.05).Conclusion CT TBLB and CT NLB are reliable and ideal non thoracotomy lung biopsy methods in the qualitative diagnose of pulmonary peripheral lesions,which fit different lesions.The comprehensive application can increase the accuracy and security of biopsy of the pulmonary peripheral lesion.