CT精确引导三维立体全身穿刺定位装置在肝脏肿瘤穿刺术中的应用研究

Application of CT-guided precise three-dimensional body puncture positioning device in the liver tumor biopsy

目的探讨cT精确引导三维立体全身穿刺定位装置在肝脏肿瘤穿刺中的应用。方法选取泰安市肿瘤防治院于2009年1月～2013年7月收治的经cT检查发现肝内占位需明确病理诊断的患者80例．采用数字表法随机分为观察组与对照组，每组各40例，观察组采用CT精确引导三维立体全身穿刺定位装置引导穿刺．对照组采用传统的cT引导下徒手穿刺，比较两组的观察成功率、手术时间、CT扫描次数、取材阳性率、穿刺术后的并发症。结果观察组一次穿刺成功率为100．0％，对照组为85．0％；观察组取材阳性率为97．5％，对照组为80．0％。观察组手术时间为（21．2±1．2）min，对照组为（37．3±2．1）min，观察组CT扫描次数（3．0±0．6）次，对照组为（8．2±2．1）次，差异有统计学意义（P〈0．05）。观察组术后出发生率为2．5％，术后未发生感染，对照组术后出血发生率为10．0％，术后感染发生率2．5％，差异无统计学意义（P〉0．05）。结论cT精确引导三维立体全身穿刺定位装置在肝脏穿刺的应用中操作简单、省时省力、一次穿刺成功率高、取材阳性率高，可减少穿刺损伤。减轻患者痛苦和x线受量，术后并发症少，值得临床推广。

Objective To investigate the application of CT-guided precise three-dimensional body puncture positioning device in the liver tumor biopsy. Methods Eighty cases of patients who were found hepatic space-occupying lesionsby by CT examination and demanded for definite pathological diagnosis from January 2009 to July 2013 at Tai＇an city tu- mour prevention and treatment hospital, were chosen and randomly divided into the observation group and the Control group by numeric table, with 40 cases in each group. The observation group received CT-guided precise three-dimensional body puncture positioning device for biopsy, and the control group received the traditional free-hand CT-guided puncture. The success rate, operation time, CT scan times, positive rate of sampling and puncture complications were observed. Results The one-time puncture success rate in the observation group was 100.0%, and that in the control group was 85.0%. The positive rate of sampling in the observation group was 97.5%, and that in the control group was 80.0%. The operation time in the observation group was （21.2±1.2） min, and that in the control group was （37.3_＋2.1） min. The CT scan times in the observation group were （3.0±0.6） times, and those in the control group were （8.2±2.1） times. The differences between the two groups were statistically significant（P〈0.05）. In the observation group, the postoperative bleeding rate was 2.5% and postoperative infection did not occur.In the control group, the postoperative bleeding rate was 10.0% and the postoperative infection rate was 2.5%. The differences between the two groups were not statisti- cally significant（P〉0.05）. Conclusion CT-guided precise three-dimensional body puncture positioning device in the liver tumor biopsy has simple operation, can save time and effort, reduce the puncture injuries and X-ray dose, and al- leviate the suffering of patients ,with high one-time puncture success rate and high positive rate of sampling and fewer complications. So, it is worthy of clinical promotion.