3D打印共面穿刺模板在肺亚厘米结节穿刺中的临床应用

Clinical Application of 3D Printing Coplanar Puncture Template in Guided Puncture of Subcentimeter Pulmonary Nodules

目的研究3D打印共面穿刺模板在肺亚厘米结节穿刺中的临床应用价值。方法选取2020年3月~2021年6月来笔者医院就诊的肺亚厘米结节患者46例。采用3D打印共面穿刺模板辅助CT引导下对所有患者进行穿刺活检。对穿刺成功率、术后病理结果、并发症出现情况、及患者临床特征进行记录并分析。结果3D打印共面穿刺模板辅助CT引导下肺亚厘米结节穿刺的成功率为97.8%,穿刺成功的患者中恶性病变共17例(37.8%),肺腺癌12例(26.7%),肺鳞癌3例(6.7%),转移癌2例(4.4%);良性病变共28例(62.2%),慢性炎症反应17例(37.8%),肉芽肿性炎6例(13.3%),结核2例(4.4%),不典型腺瘤样增生2例(4.3%),肺内淋巴结1例(2.2%)。有27例(58.7%)患者穿刺后出现并发症,为针道出血15例(32.6%),咳血3例(6.5%)和气胸9例(20.0%)。良、恶性结节患者在结节直径、患者性别和结节位置比较,差异有统计学意义(P<0.05)。结论3D打印共面穿刺模板辅助CT引导技术在肺亚厘米结节穿刺中成功率高,安全性好,具有较高的临床应用价值。

Objective To investigate the clinical application of 3D printing coplanar puncture template in puncture biopsy of subcentimeter pulmonary nodules.Methods A total of 46 patients with pulmonary subcentimeter nodules who treated in our hospital from March 2020 to June 2021 were selected.All patients underwent 3D printing coplanar puncture template assisted CT guided puncture biopsy.The success rate of puncture biopsy,pathological results,complications of puncture and clinical characteristics were analyzed.Results The success rate of 3D printing coplanar puncture template assisted CT guided puncture biopsy was 97.8%.Among the patients of successful biopsy,there were 17 cases of malignant lesions(37.8%),12 cases of lung adenocarcinoma(26.7%),3 cases of lung squamous cell carcinoma(6.7%),and 2 cases of metastatic carcinoma(4.4%),There were 28 benign lesions(62.2%),17 cases of chronic inflammation(37.8%),6 cases of granulomatous inflammation(13.3%),2 cases of tuberculosis(4.4%),2 cases of atypical adenomatous hyperplasia(4.3%),and 1 case of intra-pulmonary lymph node(2.2%).The incidence rate of puncture wound bleeding was 32.6%,the incidence rate of hemoptysis was 6.5%and the incidence rate of pneumothorax was 20.0%.There were statistically significant differences in diameter gender and location of nodules between benign and malignant lesions(P<0.05).Conclusion 3D printing coplanar puncture template assisted CT guided puncture biopsy is safe and with a high success rate.It has a high clinical application value in the puncture of subcentimeter pulmonary nodules.