“呼吸针控”在CT引导下经皮肺穿刺近膈小病灶中的应用

Application of breathing control with positioning needle in CT-guided percutaneous puncture for pulmonary small lesions near diaphragm

目的 探讨“呼吸针控”在CT引导下经皮肺穿刺近膈小病灶中的应用价值。方法 对53例肺部疾病患者[肺内近膈小病灶共53个（直径〈3cm）]进行CT引导下经皮肺穿刺活检（n=34）或微波消融术（n=19）,穿刺时全部采用“呼吸针控”法,术后及时行CT复查,随访1~5天。结果 53个病灶一次穿刺成功率为100%（53/53）。3例（3/53,5.66%）术后CT复查发现少量气胸,未予特殊处理自行吸收;未发现大量气胸等严重并发症,无穿刺相关死亡病例。术后随访未出现迟发型气胸。结论 “呼吸针控”法用于CT引导下经皮肺穿刺近膈小病灶安全可行,值得推广。

Objective To explore the application value of breathing control with positioning needle in CT-guided percuta- neous puncture for pulmonary small lesions near diaphragm. Methods Totally 53 pulmonary disease patients with 53 small lesions （diameter〈3 cm） near diaphragm underwent percutaneous lung biopsy （n=34） or microwave ablation （n =19） with the guidance of CT imaging, and breathing control with positioning needle was adopted during lung puncture. CT was performed immediately after the operation, and the patients were followed up by 1 to 5 days. Results The one-time punc- ture success rate of 53 lesions was 100% （53/53）. Three cases （3/53, 5.66%） of postoperative CT review found a small amount of pneumothorax, which were self absorption with no special treatment. There were no serious complications such as large pneumothorax, and no death case related to lung puncture. Conclusion It is safe and feasible to control breathing with positioning needle in CT-guided percutaneous puncture for pulmonary small lesions near diaphragm and worthy of pro-motion.