摘要
目的 探讨切割活检针在肺部疾病诊断中的价值及安全性。方法 回顾性分析我院2007年1月至2012年10月CT引导下经皮肺活检226例患者的233次活检资料。结果 肺部孤立性团块病灶、单发、多发性结节病灶、片状、实变病灶患者226例，其中男151例，女75例，年龄在15—89岁，平均（57．29±15．78）岁。患者肺部团快影直径〉3em，1．5cm≤结节病灶直径≤3cm，片状、实变病灶93cm×3cm。经皮肺活检穿刺成功率93．6％（218／233），获得病理诊断188例次，诊断准确性86．2％（188／218）。获得病理诊断，但不能反映全貌7．4％（14／188）。经皮肺活检气胸发生率9％，咯血9．9％，胸痛3．9％。病理诊断188例患者中，肿瘤70．2％，非肿瘤病变29．8％。肿瘤病理中不能反映全貌7．6％（10／132），非肿瘤为7．1％（4／56），两组无明显差异（P〉0．75）。团块状阴影肺活检的阳性率88．2％（135／153），不能反映全貌5．9％（8／135）。片状、实变阴影阳性率70．4％（38／54），不能反映全貌的13．2％（5／38）。单发或多发性结节阴影阳性率78．9％（15／19），不能反映全貌的0例。团块组获得病理的阳性率高于片状、实变组，差异显著（P〈0．005）；团块组与结节组，实变组与结节组比较无显著差异（P〉0．05）。团块组与片状、实变组无法反映全貌的分别为5．9％，13．2％，无统计学意义（P〉0．1）。结论 ①CT引导下切割活检针经皮肺活检对肺部病灶有较高诊断价值，并发症较少，是创伤小、操作简单、安全的诊断手段；②CT引导下切割针经皮肺活检团块状病灶获得病理诊断的阳性率高于片状、实变病灶。片状、实变病灶仍有较高的阳性率；③切割针肺活检对于非肿瘤病变及片状、实变病灶也具有较高的诊断价值。
Objective To evaluate the value and safety of cutting needle percutanous lung biopsy in the diagnosis of pulmonary disease. Method The study involved 226 patients who underwent 233 times CT guided cutting percutanous lung biopsy from January 2007 to October 2012 in our hospital. Clinic data, lung CT images, pathological results and complication of the patients were retrospectively analyzed. Results Lung CT image of 226 patients （151 male, 75 female; age range 15-89 years; mean 57.29 ±15.78 years） showed solitary pulmonary mass lesion （ diameter 〉 3 cm） , single or multiple nodular lesions （ 1.5 cm≤diameter ≤ 3 cm）, flaky or （ and ） consolidation lesions （ length multiplied by short diameter≥3 cm χ3 cm ）. Pathological diagnosis of 188 cases were acquired and the puncture success rate of percutaneous lung biopsy was 93.6% （218/233）, the diagnostic accuracy of 86.2% （188 /218）. Pathological diagnosis was obtained, but it did not reflect the whole picture 7.4% （14/188）. Percutaneous lung biopsy pneumothorax incidence was 9% , hemoptysis 9.9% , and chest pain was 3.9%. In 188 cases of pathological diagnosis, tumor was 70.2% , and non-neoplastic lesions was 29. 8%. Tumor pathological diagnosis did not reflect the whole picture of tumor pathology of 7.6% （10/132）, 7.1% non-tumor （4/56）, There was no significant difference in the two groups （P 〉0.75）. Lumpy shadow positive rate was 88.2% （135/153）, which did not reflect the whole picture of 5.9% （8/135）. Flake, consolidation shadow positive rate was 70.4% （38/54）, which did not reflect the whole picture of 13.2% （5/38）. Single or multiple nodular shadows positive rate was 78.9% （15/19） , which did not reflect the whole picture 0 cases. The pathologic diagnosis positive rate of clumps group was higher than that in flaky, consolidation group and the difference was significant （ P 〈 0. 005 ） ; mass group and nodules,consolidation group and nodules were compared, There was no significant differ
出处
《中华肺部疾病杂志（电子版）》
CAS
2015年第1期12-15,19,共5页
Chinese Journal of Lung Diseases(Electronic Edition)
基金
国家自然科学基金项目(81372489)
关键词
经皮肺活检
切割针
团块影
结节影
实变影
Percutaneous lung biopsy
Cutting needle
Mass shadow
Nodules shadow
Consolidation shadow
