不同频率超声探头联合引导穿刺活检诊断纵隔占位的临床研究

Different Frequencies of Ultrasonic Probes-guided Aspiration Biopsy on Diagnosis of Mediastinum Space Occupying Disease

目的探讨不同频率超声探头联合引导穿刺活检诊断纵隔占位的临床价值。方法选取2020年1月-2021年12月采用超声引导穿刺活检进行诊断的68例疑似纵隔占位患者为研究对象,其中全程采用高频超声探头引导穿刺活检的34例患者纳入观察1组,其余采用高频联合低中频超声探头引导穿刺活检的34例患者纳入观察2组,比较两组穿刺情况、取材成功率和并发症发生情况。两组患者均以外科手术病理和临床随访的形式获取最终诊断结果,以最终诊断结果为金标准,比较两组在纵隔占位中的诊断价值。结果观察2组平均穿刺次数少于观察1组,穿刺取材成功率高于观察1组(P<0.05)。观察1组诊断恶性病变率61.76%,良性病变率38.24%;经金标准最终确诊恶性病变率70.58%,良性病变率29.41%;诊断结果相比无明显差异(P>0.05)。观察2组诊断恶性病变率67.65%,良性病变率32.35%;经金标准最终确诊恶性病变率73.53%,良性病变率26.47%;诊断结果相比无明显差异(P>0.05)。观察2组准确度88.24%明显高于观察1组61.76%(P<0.05)。观察2组并发症发生率8.82%低于观察1组29.41%(P<0.05)。结论在纵隔占位诊断中先应用高频超声引导针进入病灶,可以有效避开肋间血管;再利用中低频超声探头扇形扫描显示病灶的深度和宽度,引导穿刺进入合适位置,可以保障一次取材成功,减少并发症,为患者疾病的诊断、治疗方案的选择以及预后评价提供可靠依据。

Objective To discuss the different frequencies of ultrasonic probes-guided aspiration biopsy on diagnosis of mediastinum space occupying disease.Methods 68 suspected patients with mediastinum space occupying disease of undergoing the ultrasonic probes-guided aspiration biopsy from Janaury 2020 to December 2021 were chosen as research subjects.The high-frequency ultrasonic probes-guided aspiration biopsy was performed in the observation group 1(34 cases);the highfrequency,medium-frequency and low-frequency ultrasonic probes-guided aspiration biopsy was performed in the observation group 2(34 cases).The puncture conditions,successful sampling rate,clinical complications were compared.The surgical and follow-up visit results were seen as gold standard.The diagnosis value of mediastinum space occupying disease based on different frequencies of ultrasonic probes-guided aspiration biopsy was expounded.Results The average puncture frequency in observation group 2 was lower than observation group 1;the successful sampling rate was higher than observation group 1(P<0.05);the detection rates of malignant and benign diseases in observation group 1 were 61.76%and 38.24%;the gold standard confirmed 70.58%of malignant cases and 29.41%of benign cases;no significant differences were observed(P>0.05);the detection rates of malignant and benign diseases in observation group 2 were 67.65%and 32.35%;the gold standard confirmed 73.53%of malignant cases and 26.47%of benign cases;no significant differences were observed(P>0.05);the diagnosis accuracy in observation group 2(88.24%)was significantly higher than observation group 1(61.76%)(P<0.05);the clinical complication rate in observation group 2(8.82%)was lower than observation group 1(29.41%)(P<0.05).Conclusion The high-frequency ultrasonic probes can effectively the intercostal blood vessel;besides,the medium-frequency and low-frequency ultrasonic probes can display the focal depth and width to make guidance on the proper puncturing positions,increase the successful sampling rate,reduce the clinical complications and provide basis on the disease diagnosis,the selection of treatment schemes and the evaluation of treatment prognosis.