CT引导经皮肺穿刺活检对肺部病变的诊断意义及并发症原因分析

Diagnostic significance of CT-guided percutaneous lung biopsy on lung lesions and analysis of causes of complications

目的探究CT引导经皮肺穿刺活检对肺部病变的诊断意义,并分析并发症原因。方法选择2017年11月-2018年4月在四川大学华西医院呼吸内科住院的95例患者,分析总结CT引导经皮肺穿刺活检对肺部病变的诊断意义及并发症情况。结果95例患者共行120次穿刺,穿刺成功率100%,活检结果较满意;94例经皮肺穿刺活检确诊,确诊率98.95%。其中肺部恶性肿瘤82例(86.32%),炎性结节13例(13.68%),未确诊的1例(1.05%)肺活检组织学检查证实为结缔组织增生;95例患者肺穿刺术后有20例并发症,并发症发生率为21.05%,其中气胸5例(5.26%),小量咯血11例(11.58%),胸腔积血/液各1例(1.05%),皮下出血1例(1.05%),皮下气肿1例(1.05%),未见空气栓塞、休克、血胸、针道种植等严重并发症发生。结论CT引导经皮肺穿刺活检是一种安全、准确的诊断和鉴别肺部病变的方法,并发症多较轻微,值得临床推广。

Objective To explore the diagnostic significance of CT-guided percutaneous lung biopsy on lung lesions and to analyze the causes of complications.Methods A total of 95 patients admitted to the department of respiratory medicine,West China Hospital of Sichuan University from November 2017 to April 2018 were selected.The diagnostic significance of CT-guided percutaneous lung biopsy on lung lesions and complications were analyzed.Results A total of 120 punctures were performed in 95 patients,and the success rate of puncture was 100%,and the biopsy results were satisfactory.94 cases were diagnosed by percutaneous lung biopsy with the diagnosis rate of 98.95%.Among them,there were 82cases(86.32%)of lung malignant tumors and 13cases(13.68%)of inflammatory nodules,and 1undiagnosed case(1.05%)was confirmed as connective tissue hyperplasia by lung biopsy.Among 95 patients after lung puncture,there were 20 complications with incidence rate of 21.05%,including 5cases of pneumothorax(5.26%),11 cases of small amount of hemoptysis(11.58%),each 1case of hemothorax/hydrothorax(1.05%),1case of subcutaneous hemorrhage(1.05%)and 1case of subcutaneous emphysema(1.05%),and there were no serious complications such as air embolism,shock,hemothorax and needle tract implantation.Conclusion CT-guided percutaneous lung biopsy is a safe and accurate method for the diagnosis and differentiation of lung lesions.And its complications are mild,thus it is worthy of clinical promotion.