CT引导下热消融联合活检对肺结节的诊断效能

Diagnostic efficacy of CT-guided thermal ablation combined with biopsy for pulmonary nodules

目的探究CT引导下热消融联合活检对不同大小肺结节的诊断效能。方法回顾性分析肺结节患者212例,其中112例患者进行单纯活检(单纯活检组),100例患者进行活检联合热消融(联合组),统计两组患者的技术成功率,记录患者术中、术后出现咯血情况,并记录患者术后出现肺出血、气胸等并发症情况。并以患者所取样本的确切病理诊断结果为准,评估两种方法的诊断准确率。结果两组患者的病理取材均成功进行,技术成功率均达到100%,其中单纯活检组的病理诊断准确率为84.82%,咯血发生率为5.36%,肺出血发生率为28.57%,气胸发生率为22.32%;联合组的病理诊断准确率为87.00%,咯血发生率为1.00%,肺出血发生率为11.00%,气胸发生率为14.00%;其中两组患者的病理诊断准确率、咯血发生率、气胸发生率比较,差异均无统计学意义(χ^(2)分别=0.21、1.93、2.44,P均>0.05),而联合组患者的肺出血发生率明显低于单纯活检组(χ^(2)=10.09,P<0.05)。结论CT引导下热消融联合活检安全、有效,能达到较为良好的诊断准确性。

Objective To explore the diagnostic efficacy of CT-guided thermal ablation combined with biopsy for pul⁃monary nodules of different sizes.Methods A total of 212 patients with pulmonary nodules were retrospectively ana⁃lyzed,including 112 patients who underwent biopsy alone(biopsy group)and 100 patients who underwent biopsy com⁃bined with thermal ablation(combined group).The success rate,the incidence of hemoptysis,pulmonary hemorrhage,and pneumothorax between two groups were statistically analyzed.The diagnostic accuracy of pathological samples was evaluat⁃ed based on the exact pathological diagnosis results obtained by the sampling of patients.Results The pathological sam⁃pling of the two groups of patients was successfully performed,and the technical success rate reached 100%.Among them,the pathological diagnosis accuracy rate of the biopsy group was 84.82%,the incidences of hemoptysis,pulmonary hemorrhage,and pneumothorax were 5.36%,28.57%,and 22.32%,respectively.The accuracy of pathological diagnosis in the combined group was 87.00%,the incidences of hemoptysis,pulmonary hemorrhage,and pneumothorax were 1.00%,11.00%,and 14.00%,respectively.There was no significant difference in the pathological diagnosis accuracy rate,the inci⁃dences of hemoptysis and pneumothorax(χ^(2)=0.21,1.93,2.44,P>0.05),while the incidence of pulmonary hemorrhage in the combined group was significantly lower than that in the biopsy group(χ^(2)=10.09,P<0.05).Conclusion CT-guided thermal ablation combined with biopsy is safe and effective,and can achieve relatively good diagnostic accuracy.