肺穿刺活检对血液病患者肺部感染的诊断价值及安全性分析

Analysis of diagnostic value and safety of pulmonary biopsy for pulmonary infection in patients with hematological diseases

目的分析肺穿刺活检在血液病患者肺部感染中的诊断价值及安全性。方法 37例血液病肺部感染患者,均行CT引导下经皮肺穿刺活检,观察患者的穿刺并发症情况、病理检查及组织细菌培养阳性率及治疗情况。结果①穿刺并发症:37例患者发生气胸5例,肺内出血1例,血气胸1例,并发症发生率为18.9%(7/37)。②病理检查及组织细菌培养阳性率:37例患者病理检查诊断阳性率为89.2%(33/37),组织细菌培养阳性率为56.8%(21/37),病理检查和组织细菌培养联合诊断阳性率为91.9%(34/37)。③治疗情况:3例患者转传染科治疗后痊愈出院, 2例患者因自身原因自动出院或转院,32例患者调整药物后均得到有效治疗。结论肺穿刺活检对血液病患者肺部感染具有较高的诊断价值,总体安全,值得临床推广。

Objective To analyze the diagnostic value and safety of pulmonary biopsy for pulmonary infection in patients with hematological diseases.Methods A total of 37 patients with pulmonary infection of blood disease all underwent CT-guided percutaneous lung biopsy to observe the patient’s puncture complications,positive rate of pathological examination and tissue culture and treatment conditions.Results①Puncture complications:there were 5 pneumothorax cases,1 pulmonary hemorrhage case and 1 hemopneumothorax case in 37 patients,with incidence of complications as 18.9%(7/37).②Positive rate of pathological examination and tissue culture:37 patients had positive rate of pathological examination as 89.2%(33/37)and positive rate of tissue culture as 56.8%(21/37),with positive rate of combined pathological examination and tissue bacterial infection as 91.9%(34/37).③Treatment:3 patients discharged after treatment in the infectious department,2 patients were discharged or transferred automatically for their own reasons,and 32 patients were treated effectively after adjusting the drugs.Conclusion Pulmonary biopsy has high diagnostic value for pulmonary infection in patients with hematological diseases.It is safe in general and worthy of clinical promotion.