经皮穿刺静脉-静脉体外膜肺的动物实验研究

目的在犬急性肺损伤的动物模型上探讨经皮穿刺静脉-静脉体外膜肺(V-VECMO)支持的效果。方法6只雄性犬利用油酸(0.1ml/kg)建立急性肺损伤模型。经皮穿刺右颈内静脉和右股静脉放置插管(分别是17Fr、10Fr),接ECMO管道灌注流量35～40ml/kg/min,氧气流量1～1.5L/min。ECMO前2h与呼吸机并用,呼吸机参数为SIMV模式,FiO20.5,TV5～6ml/kg,RR20次/分;后2h停止呼吸机的使用。记录注射油酸前、肺损伤出现后ECMO前、ECMO2h、ECMO4h的动脉血气值变化。结果注射油酸后4～6h,在纯氧高通气状态下犬动脉氧分压为106±15mmHg。ECMO2h动脉氧分压为98±7mmHg氧饱和度95.5±2.2%;ECMO4h动脉氧分压为67±3mmHg,氧饱和度为92.3±2.2%。ECMO过程中二氧化碳分压低于注射油酸前水平(p<0.05)。结论经皮穿刺V-VECMO可以帮助机体排出二氧化碳,吸收氧气,降低急性肺损伤的机械通气模式。

CT引导下经皮-肺穿30例临床分析

目的:探讨CT引导下经皮-肺穿刺活检的细胞学检查对临床及其他辅助检查未能确诊的两肺周边、胸膜及纵隔病变的诊断价值。方法:采用CT引导经皮-肺穿刺、针吸方法获取细胞组织标本并进行细胞学检查。结果:CT引导的细针吸取细胞学检查对肺周、胸膜及纵隔病变诊断率高、危险性小,做到了及早诊断及治疗,免除了不必要的开胸肺活检。结论:CT引导下经皮-肺穿刺是临床上一种必不可少的确诊方法。

Clinical value of CTS-guided percutaneous transthoracic biopsy in elder patients with lung cancer

Objective： To evaluate the value of CTS-guided percutaneous transthoracic biopsy for the diagnosis of pulmonary lesions in elder patients. Methods： The intact data of 78 elder patients underwent percutaneous pulmonary biopsy with a spring-core biopsy needle under CTS guidance were analyzed. The diagnosis of all the cases was confirmed by pathology and follow-up. Results： Ninety-five lung biopsies were performed in 78 cases and satisfactory tissue specimens obtained in all cases, the success rate was 100%. The diagnosis for malignant tumors and benign lesions was 72 and 6, respectively. The overall accuracy rate was 100%. Pneumothorax was noted in 5 cases （6.4%） and hemoptysis seen in 10 patients （12.8%）. Conclusion： CTS-guided percutaneous transthoracic biopsy with a spring-core biopsy needle are accurate, safe and quick for pulmonary lesions in elder patients.