超声引导下经皮同轴套管穿刺活检在周围型肺病变中的应用价值

Application Value of Ultrasound-Guided Percutaneous Coaxial Trocar Puncture Biopsyin Peripheral Pulmonary Lesions

目的:探讨超声引导下经皮同轴套管穿刺活检在周围型肺病变中的应用价值。方法:回顾性分析汕头市中心医院2015年6月～2017年10月收治的周围型肺部病变需行活检明确诊断的患者88例,分为A组与B组,A组47例采用超声引导下经皮单纯活检针活检,B组41例采用超声引导下经同轴套管穿刺活检;比较分析两组的病灶位置、大小、手术用时、活检病理结果、并发症、费用等指标的差异。结果:(1)两组患者性别、年龄、病变位置、病灶大小差异均无统计学意义(P>0.05)。(2)A组手术用时(17.23±4.05)min,B组手术用时(23.12±4.81)min,B组手术用时明显比A组长,差异有明显统计学意义(P<0.01)。A组穿刺后并发气胸2例,咯血1例; B组穿刺后并发气胸1例,无咯血发生。A组并发症发生率6.4%(3/47)较B组高2.4%(1/40),但差异无统计学意义(P>0.05)。A组45例患者获得满意取材,2例穿刺失败,穿刺成功率95.7%;B组41例均获得满意取材,穿刺成功率100%。讨论:超声引导下经皮穿刺活检技术取材成功率高、并发症少,同轴套管穿刺活检对直径较小的周围型肺部病变进行活检更显优势。

Objective To explore the value of ultrasound-guided percutaneous coaxial trocar puncture biopsyin peripheral pulmonary lesions. Methods: A retrospective analysis of 88 patients with peripheral pulmonary lesions from June 2015 to October 2017 in Shantou Central Hospital requiring biopsy for diagnosis was divided into group A and B. Among them,47 patients of group A wasperformedwithultrasound-guided percutaneous biopsy. While 41 patients in group B A wasperformedwithCoaxialtrocar.Compared the differences of lesion location, size, time of surgery, pathological results , complications, and cost. Results:(1) There were no significant differences in gender, age, lesion location and lesion size between the two groups (P>0.05).(2) The operation time of group A was (17.23±4.05) min, while group B was (23.12±4.81) min. The operation time of group B was significantly longer than that of group A(P<0.01). In group A, 2 patients had pneumothorax and 1 patient had hemoptysisafter puncture. In group B, 1 patient had pneumothorax, and no hemoptysis occurred. The complication rate in group A was 6.4%(3/47), which was higher than that in group B2.4%(1/40), but the difference has no statistically significant (P>0.05). 45 patients in group A were satisfied with the materials, 2 patients failed the puncture, the success rate of puncture was 95.7%;41 patients in group B were satisfied with the material, and the success rate of puncture was 100%. Discussion: Ultrasound-guided percutaneous biopsy has a high success rate and few complications. Coaxial trocar puncture biopsy is more advantageous for small diameter ofperipheral pulmonary lesions.