CT引导下经皮肺穿刺活检术对肺部占位性病变的临床诊断意义和安全性分析

CT-guided percutaneous pulmonary puncture biopsy in diagnosis of pulmonary nodules

目的:探索CT引导下经皮肺穿刺活检术的临床应用价值,分析产生并发症的原因和主要影响因素。方法:回顾2015年03月到2017年03月在哈尔滨医科大学附属第二医院肿瘤内科行CT引导下经皮肺穿刺活检术的138例病例资料,总结其诊断准确率、并发症的发生率及其影响因素。结果:成功获取138例患者组织标本,其中130例获得明确诊断,定性诊断率94.2%(130/138),一次活检阳性率81.9%(113/138);二次活检阳性率76.5%(13/17);三次活检阳性率100%(4/4)。并发症发生率为14.5%(20/138),其中胸膜反应1.4%(2/138)、气胸3.6%(5/138)、小咳血8.0%(11/138)、针道渗血1.4%(2/138)。所有并发症均经临床观察和对症处理后缓解,无严重并发症发生。结论:CT引导下经皮肺穿刺活检术临床价值高,适用于肺部疾病的诊断,是一种创伤性小、确诊率高、安全性较好的方法。

Objective ：To explore the clinical application value of CT-guided percutaneous pulmonary puncture biopsy,and analyze the causes of complications and main factors. Methods：A total of 138 patients in March 2015 to March 2017 with pulmonary nodules underwent CT-guided percutaneous pulmonary- puncture biopsy for further diagnosis. Results：All tissue samples were successfully obtained from the 138 patients. Among which 130 were diagnosed with a definite diagnosis. The diagnosis rate was 94.2% （130/138 ）, and the positive rate was 81.9% （113/138 ）. Secondary biopsy positive rate was 76.5% （ 13/17）, the positive rate of three biopsies was 100% （4/4）. The incidence of complications was 14.5 % （20/138）. in which the pleural response was 1.4% （2/138）, chest was 3.6% （5/ 138 ）, and hemoptisis was 8.0% （ 11/138）, and bleeding at the site of puncture was 1.4% （2/138）. All the complications were relieved by clinical observation and symptonlatic treatment, and no serious complications occurred. Conclusion ：The clinical value of CT guided percutaneous lung biopsy is very high ,which can be applied to the diagnosis of pulmonary diseases. It is a method of low trauma,high diagnosis rate and good safety.