摘要
目的探讨CT导向下胸膜穿刺活检在结核性胸膜炎诊断中的可行性及安全性。方法选取2018年8月~2019年8月在我院住院治疗的56例经皮胸膜穿刺活检患者,部分患者术前或术中行胸腔积液检查。活检完成后行细胞学及组织学检查,胸水行常规、生化、细胞学及病原学等检查。统计穿刺活检术后的并发症,以及对穿刺活检病理阳性率与胸水检测阳性率进行统计学对比。结果56例手术均顺利完成穿刺活检,术后气胸3例,出血5例,感染1例;其中41例患者行胸水细胞学检查。术后结果:肿瘤13例,结核性胸膜炎40例(其中包含5例诊断性治疗有效者),非特异性炎症3例。胸水细胞学检查:肿瘤5例,结核分支杆菌10例。胸水检查阳性率36.59%〔(5+10)/41〕,结核性胸膜炎阳性率25.00%(10/40);穿刺活检细胞学检查:肿瘤6例,结核分支杆菌10例,病理学检查明确:肿瘤13例,结核性胸膜炎35例,慢性纤维增生炎症3例,其他5例。穿刺活检阳性率85.71%〔(13+35)/56〕,结核性胸膜炎阳性率87.50%(35/40)。胸水组与活检组二者比较,阳性率及结核性胸膜炎阳性率均有明显统计学差异(P<0.05)。结论CT导向下胸膜穿刺活检安全、有效,可以明显提高结核性胸膜炎的诊断符合率。
Objective To investigate the feasibility and safety of CT-guided pleural biopsy in the diagnosis of tuberculous pleurisy.Methods 56 patients performed percutaneous biopsy in our hospital from August 2018 to August 2019,and some patients did pleural effusion examination before or during surgery.Cytology and histology examination were performed after biopsy.The complications after biopsy and the positive rate of biopsy pathology and pleural effusion were statistically compared.Results Biopsy was successfully completed in all the 56 patients,and 3 patients presented with pneumothorax,5 patients with hemorrhage and 1 patient with infection.Cytology of pleural effusion was performed in 41 patients.Postoperative results included tumor in 13 cases,tuberculous pleurisy in 40 cases(including 5 cases with effective diagnostic treatment),and non-specific inflammation in 3 cases.Cytology of pleural effusion included tumor in 5 cases,and mycobacterium tuberculosis in 10 cases.The positive rate in pleural effusion was 36.59%〔(5+10)/41〕,and the positive rate of tuberculous pleurisy was 25.00%(10/40).Cytological examination of biopsy included 6 cases of tumor,and 10 cases of mycobacterium tuberculosis;pathological examination included 13 cases of tumor,and 35 cases of tuberculous pleurisy,3 cases of chronic fibrous hyperplasia inflammation,and the other 5 cases.Positive rate of biopsy was 85.71%〔(13+35)/56〕,positive rate of tuberculous pleurisy was 87.5%(35/40).The positive rate of tuberculous pleurisy were significantly different between the two groups(P<0.05).Conclusion CT-guided pleural biopsy is safe and effective,which significantly improves the diagnostic coincidence rate of tuberculous pleurisy.
作者
李玉超
刚保江
刘胤杉
窦卫涛
LI Yuchao;GANG Baojiang;LIU Yinshan;DOU Weitao(Department of Ultrasound Diagnosis and Treatment, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, P.R.China;Xinjiang Kashi Tuberculosis Control Institute, Kashi 844000, P.R.China;CT Intervention Research Office, Shandong Medical Imaging Research Institute Affiliated to Shandong University, Jinan 250021, P.R.China)
出处
《医学影像学杂志》
2020年第7期1204-1206,1210,共4页
Journal of Medical Imaging
