增强CT引导下肺中央型病变穿刺活检的临床应用

Clinical application of central lung lesions biopsy guided by enhanced CT

目的探讨在增强CT引导下对肺中央型病变穿刺活检的阳性率和风险。方法回顾性分析2013年5月—2016年5月在增强CT引导下90例肺中央型病变经皮穿刺活检的病例资料,分析该90例患者穿刺活检阳性率、并发症发生率与肿块大小之间的关系,并与随机抽取同期90例肺周围型病变穿刺活检患者的资料进行对比分析。结果中央型病变穿刺活检阳性率随肿块直径增加而增加,但无统计学差异;并发症发生率随肿块直径增加而减少,有显著统计学差异。全部中央型的活检阳性率(80%)与周围型(88%)比较差异无显著性意义,总的并发症发生率中央型组(43%)明显高于周围型组(20%),两组比较有显著性差异(P<0.05),中央型组及所抽取周围型组均无严重并发症的发生。结论在严格评估穿刺可行性及安全性的前提下,对肺中央型病变,在增强CT引导下经皮穿刺活检是可行的、安全的;活检阳性率完全能满足临床需求,相关风险在可控范围。

Objective To investigate the positive rate and risk of of central lung lesions biopsy guided by en- hanced CT. Methods The clinical data of 90 cases of central lung lesions biopsy guided by enhanced CT were ret- rospectively analyzed. The relationship of biopsy positive rate and complication rate with tumor size was analyzed, and it was compared with the random sample of 90 patients with pulmonary peripheral lesions biopsy. Results The biop- sy positive rate increased with the increase of tumor diameter, but without statistical difference. The incidence of complications reduced with the increase of tumor diameter, with significant statistical difference. The positive biopsy rate was 80% in the central group and 88% in the around group, a and there was no significant difference. The over- all incidence of complications of the central type group （43%） was obviously higher than that of the peripheral group （20%） （P 〈 0. 05）. There was no serious complications in the two groups. Conclusion Through strict evaluation puncture under the premise of the feasibility and safety of central type lung lesions, the enhanced CT guided percuta- neous biopsy is feasible and safe. The biopsy positive rate can fully meet the demand of clinical and related risks are in the controllable range.