穿刺架辅助B超引导下实时胸膜切割活检术在渗出性胸膜炎中的应用

Application of Puncture Frame Assisted by B Ultrasound Guided Exudative Pleural Effusion in Realtime Pleural Cutting Biopsy

目的:探讨不同闭式胸膜活检术在渗出性胸腔积液诊断中的应用价值。方法:选取2016年1月-2018年5月本院就诊的原因不明渗出性胸腔积液患者120例作为研究对象,根据不同治疗方案将其分为观察组(n=56)和对照组(n=64)。观察组给予穿刺架辅助B超引导下实时胸膜切割活检术+钩针胸膜活检术,对照组给予B超引导下胸膜切割活检术+钩针胸膜活检术,比较两组活检成功和诊断阳性、手术时间和费用以及并发症发生情况。结果:观察组活检组织获取成功情况明显高于对照组;且诊断阳性率为85.71%(48/56),明显高于对照组的70.31%(45/64),差异均有统计学意义(X^2=41.816、4.063,P<0.05)。观察组阳性结果中病理可分型率为85.42%,明显高于对照组的66.67%,差异有统计学意义(X^2=4.521,P<0.05)。两组气胸、胸痛、胸膜反应和血胸的发生情况比较,差异均无统计学意义(P>0.05)。结论:穿刺架辅助B超引导下进行实时胸膜切割活检术+钩针胸膜活检术可提高胸腔积液的诊断阳性率,值得临床工作中进行推广应用。

Objective:To investigate the application value of different kinds of closed pleural biopsy in the diagnosis of exudative pleural effusion.Method:A total of 120 patients with unidentified exudative pleural effusion treated in our hospital from January 2016 to May 2018 were selected the study objects.According to different treatment regimens,they were divided into observation group(n=56)and control group(n=64).The observation group was given puncture frame assisted B ultrasound guided real-time pleura cutting biopsy+pleural biopsy needle,the control group was given B ultrasound guided pleural cutting biopsy+needle biopsy of pleura,the The success and positive diagnosis,operation time and cost and complications between the two groups were compared.Result:The success rate of biopsy tissue in the observation group was significantly higher than that in the control group;and the positive rate of diagnosis was 85.71%(48/56),which was significantly higher than 70.31%(45/64)in the control group,the differences were statistically significant(χ2=41.816,4.063;P<0.05).The pathological typing rate of positive results in the observation group was 85.42%,which was significantly higher than 66.67%of the control group,the difference was statistically significant(P<0.05).There were no significant differences in the incidence of pneumothorax,chest pain,pleural reaction and hemothorax between the two groups(P>0.05).Conclusion:Puncture frame assisted B ultrasound guidance real-time pleural cutting biopsy+pleural biopsy needle can improve the positive rate of pleural effusion,which is worthy of popularization and application in clinical work.