摘要
目的探讨电子计算机X射线断层扫描(CT)引导下经皮肺穿刺活检术在职业性尘肺病(以下简称"尘肺病")诊断中的应用价值。方法对63例进行尘肺病诊断的患者行CT引导下经皮肺穿刺活检术,分析经皮肺穿刺活检术的成功率、尘肺病理学检查结果的阳性率及诊断准确率。结果 63例患者穿刺成功率为100.0%。病理检查结果中发现尘肺样改变60例,阳性率达95.2%,其中尘性弥漫性纤维化56例、粉尘沉积48例、尘性结节32例;结核肉芽肿5例,肿瘤、巨噬细胞性肺炎、感染各1例。根据病理检查结果最后确诊单纯尘肺病54例、职业性硬金属肺病1例、尘肺病合并肿瘤1例、尘肺病合并结核4例、单纯结核2例,诊断准确率为98.4%。结论 CT引导下的经皮肺穿刺活检术作为一种理想的获得肺组织病理标本的临床方法,检出尘肺样病理改变的阳性率高,对尘肺病诊断准确率高,在尘肺病的诊断与鉴别诊断中具有较高的应用价值。
Objective To investigate the application value of computed tomograph（ CT） guided percutaneous lung biopsy in the diagnosis of occupational pneumoconiosis（ the following is referred to as ＂pneumoconiosis＂）. Methods A total of63 cases of CT-guided percutaneous lung puncture biopsy from patients with pneumoconiosis,were analyzed for the successful rate of percutaneous lung puncture,the positive rate of pneumoconiosis pathological results and diagnostic accuracy. Results The successful rate of puncture was 100. 0% in these 63 cases. Pathological examination revealed60 cases of pneumoconiosis like change,with a positive rate of 95. 2%. Among them,56 cases were diffuse fibrosis,48 cases were dust deposition,and 32 cases were dusty nodules. There were 5 cases of tuberculosis granuloma,1 case of tumor,1 case of macrophage pneumonia and 1 case of infection. According to the pathological examination results,54 cases of simple pneumoconiosis,1 case of occupational hard metal lung disease,1 case of pneumoconiosis combined with tumor,4 cases of pneumoconiosis combined with tuberculosis and 2 cases of simple tuberculosis were confirmed. The diagnostic accuracy was 98. 4%. Conclusion CT guided percutaneous lung biopsy is an ideal clinical method for obtaining pathological specimens of lung tissue. The positive rate of detecting pneumoconiosis pathological changes is high.The accuracy of pneumoconiosis diagnosis is high. It has high application value in the diagnosis and differential diagnosis of pneumoconiosis.
作者
戴伟荣
胡建安
李莉
李欣
刘文峰
刘浪
DAI Weirong;HU Jianan;LI Li;LI Xin;LIU Wenfeng;LIU Lang(Hunan Institute of Occupational Disease Prevention and Treatment,Changsha,Hunan 410007,China)
出处
《中国职业医学》
CAS
北大核心
2018年第4期485-488,共4页
China Occupational Medicine
