摘要
目的探讨CT引导下老年人肺部肿块及肺结节经皮肺穿刺活检术的临床应用价值。方法390例老年人肺部肿块及肺结节患者为研究对象,均行经皮肺穿刺活检术。分析病灶直径及穿刺深度与并发症的相关性;观察肺穿刺活检病理组织学诊断结果;观察并发症的治疗效果。结果390例患者均穿刺成功,成功率为100.0%,其中382例患者一次穿刺成功,其余8例患者行2次穿刺,最终穿刺成功。通过相关散点图分析,气胸、咯血发生率与病灶直径呈负相关(r=-0.436、-0.341,P<0.05),与穿刺深度呈正相关(r=0.990、0.968,P<0.05)。病理组织学诊断结果显示:恶性病变262例、占67.2%,良性病变128例、占32.8%。390例患者中,共发生并发症55例,占14.1%。其中包括气胸34例(迟发型大量气胸6例),咯血21例。对症处理后均转归良好,没有纵隔气肿、空气栓塞、死亡等情况发生。结论CT引导下经皮肺穿刺活检术是一种创伤小且实用的定性诊断方法,对老年人肺部肿块、肺结节的诊断具有较高的临床应用价值。
Objective To discuss the clinical value of CT-guided percutaneous lung biopsy in the elderly.Methods 390 elderly patients with pulmonary masses and nodules were studied,and all of them underwent percutaneous lung biopsy.The correlation between lesion diameter and puncture depth and complications was analyzed;the histological diagnosis of lung biopsy was observed;and the therapeutic effect of complications was observed.Results All 390 patients were successfully punctured,with a success rate of 100.0%,of which 382 patients were successful in one puncture,and the remaining 8 patients were punctured twice,and the puncture was successful in the end.By correlation scatter diagram analysis,the incidence of pneumothorax and hemoptysis was negatively correlated with lesion diameter(r=-0.436,-0.341;P<0.05),and positively correlated with puncture depth(r=0.990,0.968;P<0.05).The histopathological diagnosis showed that there were 262 cases of malignant lesions,accounting for 67.2%,and 128 cases of benign lesions,accounting for 32.8%.Among the 390 patients,55 cases(14.1%)had complications,including 34 cases of pneumothorax(6 cases of delayed massive pneumothorax)and 21 cases of hemoptysis.All patients improved after symptomatic treatment,and no mediastinal emphysema,air embolism,death,etc.occurred.Conclusion CT-guided percutaneous lung biopsy is a small trauma and practical qualitative diagnostic method,and has high clinical application value in the diagnosis of pulmonary mass and nodules in the elderly.
作者
张有智
郝显华
赵空军
聂良良
张英龙
董都选
张春峰
杨智
黄松涛
ZHANG You-zhi;HAO Xian-hua;ZHAO Kong-jun(Department of Radiology,Baoji High-tech People’s Hospital,Baoji 721013,China)
出处
《中国实用医药》
2022年第1期12-15,共4页
China Practical Medicine
基金
宝鸡市科学技术局社会发展攻关课题(项目编号:16SFGG3-18)。
