细针固定法在下肺小结节CT引导下穿刺活检术中的应用

Application of Fine Needle Fixation in CT Guided Percutaneous Biopsy of Small Nodules of Lower Lung

目的探讨细针固定法在下肺小结节CT引导下经皮穿刺活检术中的临床应用价值。方法选取2019年5月至2021年9月于西部战区总医院进行CT引导下行下肺小结节穿刺活检病例86例为研究对象,采用随机数字表法分为试验组和对照组,每组43例。试验组采用细针固定法穿刺活检,对照组以传统单针穿刺法穿刺活检。对比两组下肺小结节穿刺活检情况、并发症发生率、手术时间、术中调针次数及患者所受辐射有效剂量的差异。结果对照组有效取材成功率为81.4%(35/43),低于试验组95.3%(41/43)(P<0.05);对照组气胸、肺内出血和痰中带血等总并发症发生率为46.5%(20/43),高于试验组25.6%(11/43)(P<0.05);对照组手术时间为(18.5±3.9)min,高于试验组(16.3±3.1)min(P<0.05);对照组调针次数为(4.6±0.8)次,高于试验组(3.8±0.8)次(P<0.05);对照组辐射剂量为(3.94±0.31)mSv,高于试验组(3.58±0.34)mSv(P<0.05);对照组CT测量结节移动幅度为(0.76±0.28)cm,高于试验组(0.48±0.11)cm(P<0.05)。结论细针固定法可提高下肺小结节穿刺活检有效取材成功率,减少并发症发生率、调针次数和患者辐射剂量,缩短手术操作时间,在下肺小结节CT引导下穿刺活检术中具有一定临床应用价值。

Objective To investigate the clinical value of fine needle fixation in CT guided percutaneous biopsy of small nodules of lower lung. Methods A total of 86 cases undergoing CT guided percutaneous biopsy of small nodules of lower lung in General Hospital of Western Theater Command from May 2019 to September 2021 were selected. They were divided into experimental group(n=43, fine needle fixation percutaneous biopsy) and control group(n=43, traditional single needle percutaneous biopsy) by random number table method. Effective sampling success rate, incidence of complications, duration of operation, times of intraoperative needle adjustment, and effective dose of radiation were compared between the two groups. Results The effective sampling success rate in the control group was 81.4%(35/43), which was lower than 95.3%(41/43) in the experimental group(P<0.05). The total incidence of complications such as pneumothorax, intrapulmonary hemorrhage and blood in sputum in the control group was 46.5%(20/43), which was higher than 25.6%(11/43) in the experimental group(P<0.05). The average duration of operation in the control group was(18.5±3.9) min, which was longer than(16.3±3.1) min in the experimental group(P<0.05). The average times of intraoperative needle adjustment in the control group was(4.6±0.8) times, which was higher than(3.8±0.8) times in the experimental group(P<0.05). The average effective dose of radiation in the control group was(3.94±0.31) mSv, which was higher than(3.58±0.34) mSv in the experimental group(P<0.05). The average moving range of nodules measured by CT in the control group was(0.76±0.28) cm, which was higher than(0.48±0.11) cm in the experimental group(P<0.05). Conclusion Fine needle fixation has certain clinical value in CT guided percutaneous biopsy of small nodules of lower lung since it can improve the effective sampling success rate, reduce incidence of complications, duration of operation, times of intraoperative needle adjustment, and effective dose of radiation.