提高穿刺肺内小病灶活检阳性率的一种新方法

A NEW METHOD IMPROVING POSITIVE RATE OF NEEDLE BIOPSY FOR SMALL FOCUS IN LUNG

目的 :探讨抽吸针与活检枪组合使用的临床应用价值。方法 :采用自制 1 4号抽吸针与 BARD公司产 1 9.5 G活检枪 ,组合成同轴穿刺器 ,对 68例肺内小病灶 (直径≤ 3cm)穿刺活检。结果 :68例中鳞状细胞癌2 8例 ,腺癌 1 9例 ,结核球 8例 ,炎性假瘤 5例 ,霉菌球 3例 ,错构瘤 2例 ,肺脓肿、肺硬化性血管瘤、胰腺癌肺转移各 1例。穿刺活检阳性率为 98.5 % ( 67/68) ,组织学诊断正确率为 94.1 % ( 64/68) ,气胸发生率为 4.4%( 3/68) ,咯血发生率为 2 .9% ( 2 /68)。结论 :国产抽吸针与活检枪组合使用 ,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 study combined application of aspirating needle and automated needle.Methods:14# aspirating needle(native product)and 19 5 G automated needle were made up into a penetrator with same axis which was used to puncture 68 patients with small pulmonary focus(Φ≤3 cm) for biopsy.Results:In the 68 patients,there were cell carcinoma (28 cases),adenocarcinoma(19 cases),tuberculoma(8 cases),inflammatory pseudotumor(5 cases),pneumomycosis(3 cases),hamartoma(2 cases),pulmonary abscess(l case),pulmonary sclerosing hemangioma(l case) ,and pulmonary metastatic tumor from pancreatocarcinoma (1 case).The positive rate of needle biopsy was 98 6% (67/68),accuracy of histodiagnosis was 94 1%(64/68),pneumothorax occured in 4 4%(3/68),and hemoptysis occurred in 2 9%(2/68).Conclusion:The combination of native aspirating needle with automated needle can improve positive rate of needle biopsy and accuracy of histodiagnosis,and it has been proved to be an effective and safe means and should be popularized.