超声引导胸膜活检术对渗出性胸腔积液的诊断价值

Diagnostic value of ultrasound-guided percutaneous core-needle biopsy for exudative pleural effusion

目的:探讨超声引导经皮胸膜活检术对胸膜病变检出的阳性率和安全性。方法:对105例胸膜患者于超声引导下经皮穿刺活检,以取出目标组织者为取材成功,否则为不成功。全部病例以超声引导穿刺活检病理肯定诊断或随访6个月为最后诊断。结果:105例胸膜患者取材成功率为100%,病例中恶性44例,其中腺癌19例,鳞癌8例,小细胞癌4例,间皮瘤13例;良性61例,其中结核性胸膜炎50例,慢性炎症11例。病理阳性率为89.5%。穿刺过程中3例出现胸膜反应,1例出现咯血。复查胸片均未发现气胸。结论:超声引导下经皮穿刺活检诊断胸膜病变的准确性高,并发症低,且安全性好,是临床诊断胸膜病变的有效方法。

Objective： To investigate the positive rate and safety of ultrasound-guided percutaneous core-needle biopsy（US-PCNB） in pleura disease. Methods： One hundred and five patients with pleura disease underwent ultrasound-guided biopsy using 18 G coarse needle. A biopsy was considered technically successful if a targeted tissue was obtained. Final diagnosis was made based on either pathology was taken as the final diagnosis or the result of follow–up for more than six months. Results： The successful rate of sampling 18 G was100%. 44 cases were diagnosed as malignant, among them, 19 cases as adenocacinoma, 8 cases as squamous cell carcinoma, 4 cases as small cell carcinoma, 13 cases as mesothelionma. 61 cases were diagnosed as benign. Among them, 50 cases as tuberculous pleurisy, and 11 cases were chronic inflammation. The positive rate was 89.5% in pathological diagnosis. There was no bleeding in intraoperative, 3 patients had pleural reaction,1 patients had hemoptysis. Pneumothorax have not appeared during rechecking sternite. Conclusion： US-PCNB is sensitive and accurate in diagnosis of pleura disease with a lower incidence of complication, it is an effective technique in confirming the diagnosis of pleura disease.