本文關(guān)鍵詞： CT引導(dǎo) 肺癌 CT增強(qiáng) 同軸穿刺活檢 肺占位 氣胸　出處：《北華大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探討CT增強(qiáng)掃描同軸穿刺活檢在肺部腫瘤診斷中的臨床應(yīng)用價(jià)值。方法:選取94例肺部腫瘤性病變的門診或住院病人,將其隨機(jī)分為對照組與研究組,對照組43例,實(shí)驗(yàn)組51例,采用螺旋CT引導(dǎo)下經(jīng)皮穿刺肺部占位性病變,對照組采用CT平掃定位,研究組采用CT增強(qiáng)定位,均應(yīng)用同軸穿刺活檢,對比兩組平均活檢次數(shù)、穿刺取材滿意率、病理回報(bào)陽性率、肺惡性腫瘤檢出率以及并發(fā)癥(出血、氣胸、感染、氣體栓塞)發(fā)生的幾率,比較兩種定位引導(dǎo)方法的影像學(xué)價(jià)值。結(jié)果:1.對照組患者43例活檢次數(shù)51次,其中6名患者進(jìn)行二次活檢,2名患者進(jìn)行三次活檢,取材滿意率達(dá)74.42%;研究組患者51例活檢次數(shù)53次,其中2名患者進(jìn)行二次活檢,取材滿意率達(dá)90.20%。研究組與對照組平均活檢次數(shù)比較、取材滿意率比較(P0.05)差異有統(tǒng)計(jì)學(xué)意義。2.對照組患者43例,32例獲得陽性結(jié)果,病理陽性率為58.14%,惡性病灶檢出率51.16%,其中鱗癌1例,腺癌13例,神經(jīng)內(nèi)分泌腫瘤1例,非小細(xì)胞癌4例,惡性胸膜間皮瘤1例,轉(zhuǎn)移瘤2例,錯(cuò)構(gòu)瘤1例,神經(jīng)鞘瘤1例,硬化性血管瘤1例。研究組患者51例46例獲得陽性結(jié)果,病理陽性率為80.39%,惡性病灶檢出率74.51%,其中鱗癌2例,腺鱗癌3例,腺癌21例,大細(xì)胞癌1例,神經(jīng)內(nèi)分泌腫瘤1例,小細(xì)胞肺癌1例,非小細(xì)胞癌6例,轉(zhuǎn)移瘤2例,惡性胸膜間皮瘤1例,嗜酸性肉芽腫1例,結(jié)核2例。研究組與對照組病理陽性率比較、惡性腫瘤檢出率比較(P0.05)差異有統(tǒng)計(jì)學(xué)意義。3.對照組43例患者經(jīng)CT平掃掃同軸穿刺活檢,有24例出現(xiàn)并發(fā)癥,其中氣胸21例(48.84%),出血19例(44.17%);研究組51例患者出現(xiàn)并發(fā)癥21例(41.18%),其中氣胸17例(33.33%),出血11例(21.57%)。兩組各有2例患者肺壓縮體積大于30%,胸悶憋氣明顯,均給予閉式引流后痊愈;對照組1例患者出現(xiàn)肋間動(dòng)脈損傷出血,行介入栓塞止血。其余氣胸、出血患者未給予特殊處理,72小時(shí)后檢查均完全吸收。兩組均無術(shù)后感染及氣體栓塞病例。術(shù)后出現(xiàn)穿刺部位疼痛5人,其中對照組3人,研究組2人,給予雙氯芬酸鈉緩釋片止痛,疼痛48-72小時(shí)后均消失。兩組均未出現(xiàn)胸膜反應(yīng)并發(fā)癥。研究組與對照組并發(fā)癥發(fā)生率比較(P0.05)差異有統(tǒng)計(jì)學(xué)意義。結(jié)論:CT增強(qiáng)掃描同軸穿刺活檢術(shù)對肺部腫瘤性病變診斷具有重要的臨床應(yīng)用價(jià)值,與常規(guī)CT平掃穿刺活檢術(shù)比較:平均穿刺次數(shù)減少,取材滿意率增加15.78%,病理陽性率增加22.25%,惡性腫瘤檢出率增加23.35%,并發(fā)癥發(fā)生率減少14.63%。
[Abstract]:Objective: To investigate the CT enhanced scan coaxial biopsy in the diagnosis of lung cancer in clinical application. Methods: 94 cases of lung tumors in outpatient or inpatient, they were randomly divided into control group and study group, 43 cases in the control group, 51 cases in the experimental group, using spiral CT guided percutaneous puncture lung lesions, the control group using CT scan positioning, the study group using the enhanced CT positioning, both the application of coaxial biopsy, compared two groups of average times of puncture biopsy, the satisfactory rate of return, the pathological positive rate of malignant lung tumor detection rate and complications (bleeding, pneumothorax, infection, air embolism) occurred the probability value, comparison of two kinds of imaging guided method. Results: 1. patients with biopsy in 43 cases of the control group for 51 times, of which 6 patients underwent the two biopsy, 2 patients underwent the three biopsy specimens, the satisfaction rate was 74.42%; 51 cases of study group were treated once biopsy 鏁，

本文編號：1512393