【摘要】：目的 探討CT引導(dǎo)下經(jīng)皮肺穿刺活檢在肺部腫塊診斷中的意義及并發(fā)癥防治措施,分析產(chǎn)生并發(fā)癥的原因及主要影響因素,以提高CT引導(dǎo)下經(jīng)皮穿刺肺活檢術(shù)穿刺成功率。方法 對(duì)2015年1月至2016年6月住院且臨床難以確診的肺部腫物患者438例行CT引導(dǎo)下經(jīng)皮肺穿刺活檢術(shù),并通過病理學(xué)確診。結(jié)果 438例患者全部穿刺成功,穿刺成功率100.0%,一次穿刺陽(yáng)性率94.9%,二次穿刺陽(yáng)性率100.0%。438例病理診斷為惡性病變379例(86.5%),良性病變37例,不確定22例。經(jīng)皮穿刺活檢的敏感性、特異性、準(zhǔn)確率分別為97.9%(376/384)、94.4%(51/54)、97.4%(427/438)。一次穿刺出現(xiàn)氣胸33例(7.5%),痰中帶血62例(14.2%),胸膜反應(yīng)7例(1.6%),針道滲血6例(1.4%),未見針道種植。15例患者第二次穿刺出現(xiàn)氣胸7例(46.6%),痰中帶血1 1例(7 3.3%)。合并慢性阻塞性肺疾病(簡(jiǎn)稱慢阻肺)、肺部病灶3 c m或穿刺深度≥5 c m的患者氣胸和痰中帶血發(fā)生率更高,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論 CT引導(dǎo)下經(jīng)皮肺穿刺活檢術(shù)對(duì)肺部腫塊具有良好的臨床診斷價(jià)值,穿刺進(jìn)針深、病灶小、有慢阻肺的患者穿刺并發(fā)癥發(fā)生率越高。CT引導(dǎo)下經(jīng)皮肺穿刺活檢術(shù)是一種創(chuàng)傷相對(duì)小、確診率高、安全性較好的方法。
[Abstract]:Objective to investigate the significance of percutaneous lung biopsy guided by CT in the diagnosis of pulmonary masses and the prevention and treatment of complications, and to analyze the causes and main influencing factors of complications in order to improve the success rate of percutaneous lung biopsy guided by CT. Methods from January 2015 to June 2016, 438 patients with pulmonary masses hospitalized from January 2015 to June 2016 were treated with percutaneous pulmonary biopsy guided by CT and confirmed by pathology. Results all the 438 patients were punctured successfully, the successful rate of puncture was 100.0%, the positive rate of primary puncture was 94.9, the positive rate of secondary puncture was 100.0.438 cases were diagnosed as malignant lesions in 379 cases (86.5%), benign lesions in 37 cases and uncertainty in 22 cases. The sensitivity, specificity and accuracy of percutaneous biopsy were 97.9% (376 / 384) and 94.4% (51 / 54) or 97.4% (427 / 438), respectively. There were 33 cases (7.5%) with pneumothorax, 62 cases (14.2%) with blood in sputum, 7 cases (1.6%) with pleural reaction, 6 cases (1.4%) with bleeding from needle canal, 7 cases (46.6%) with pneumothorax and 11 cases (73.3%) with blood in sputum. The incidence of pneumothorax and blood in sputum was higher in patients with chronic obstructive pulmonary disease (COPD), pulmonary focus 3 cm or puncture depth 鈮，

本文編號(hào)：2220319