術(shù)前經(jīng)皮粗針穿刺活檢在肢體軟組織病變診斷中的應(yīng)用
本文選題:軟組織病變 + 軟組織腫瘤; 參考:《山東醫(yī)藥》2017年31期
【摘要】:目的探討術(shù)前經(jīng)皮粗針穿刺活檢(CNB)對(duì)肢體軟組織病變的診斷價(jià)值。方法回顧性分析93例在我院行CNB的軟組織病變患者的臨床資料。結(jié)果本組93例患者共行CNB 94次,其中3次失敗,穿刺成功率為97%(91/94)。本組患者最終診斷為惡性病變60例,良性病變33例。91例穿刺成功患者中,真陽性56例,假陽性0例,真陰性32例,假陰性3例。CNB對(duì)于明確病變是否為惡性的敏感性、特異性、準(zhǔn)確率、陽性預(yù)測值、陰性預(yù)測值分別為95%、100%、97%、100%、91%。本組共17例患者穿刺前后治療方案進(jìn)行了調(diào)整,其中12例穿刺前擬行手術(shù)切除,穿刺后改行非手術(shù)治療;5例手術(shù)方式發(fā)生變化,穿刺前擬行廣泛切除,穿刺后僅行病灶切除或清理術(shù)。結(jié)論 CNB在肢體軟組織病變診斷中,尤其在良惡性病變鑒別方面,具有較高的敏感性、特異性及準(zhǔn)確率。
[Abstract]:Objective to evaluate the value of preoperative percutaneous transdermal needle biopsy (CNB) for the diagnosis of soft tissue lesions of the limbs. Methods the clinical data of 93 patients with soft tissue lesions of CNB in our hospital were retrospectively analyzed. Results 93 cases of this group were treated with CNB 94 times, of which 3 failed and the puncture success rate was 97% (91/94). The final diagnosis of this group was 60 cases of malignant lesions. Among the 33 patients with benign lesions, 56 were true positive, 0 were false positive, 32 were true negative, 3 cases of false negative.CNB were sensitive to whether the lesions were malignant, specificity, accuracy, positive predictive value and negative predictive value were 95%, 100%, 97%, 100%, 91%., and 17 patients were adjusted before and after puncture. In the middle 12 cases, 12 cases were cut out before the puncture, and the non operative treatment was changed after the puncture. 5 cases were changed in the mode of operation, extensive resection was made before the puncture, and only the lesion resection or cleaning was performed after the puncture. Conclusion the CNB has high sensitivity, specificity and accuracy in the diagnosis of soft tissue lesions, especially in the identification of benign and malignant lesions.
【作者單位】: 河北醫(yī)科大學(xué)第三醫(yī)院;河北骨科生物力學(xué)重點(diǎn)實(shí)驗(yàn)室;
【基金】:河北省衛(wèi)生計(jì)生委重點(diǎn)科技研究計(jì)劃(20150285)
【分類號(hào)】:R738.6
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