摘要
目的:探究CT引导下肺穿刺活检术对肺小结节的诊断价值及术后并发气胸的危险因素。方法:以2018年6月1日~2021年5月31日102例肺小结节患者为研究对象,均行CT引导下肺穿刺活检术及MSCT检查。以临床诊断结果为标准,比较两种检查方法对肺小结节的诊断价值。根据术后24h内气胸发生情况分为气胸组及非气胸组,分析影响患者术后发生气胸的危险因素。结果:CT引导下肺穿刺活检术与临床诊断结果的一致性(Kappa=0.887)大于MSCT(Kappa=0.598);CT引导下肺穿刺活检术诊断肺小结节的AUC大于MSCT(P<0.05);根据气胸发生情况将患者分为气胸组(n=27)及非气胸组(n=75),气胸组在病灶深度≥3cm、病灶密度不均匀、合并肺气肿、合并肺大疱、穿刺时间≥15min方面的人数比例高于非气胸组;病灶深度≥3cm、合并肺气肿、合并肺大疱、穿刺时间≥15min是影响患者肺穿刺术后发生气胸的危险因素。结论:CT引导下肺穿刺活检术对肺小结节良恶性的鉴别价值较高,且病灶深度≥3cm、合并肺气肿、合并肺大疱、穿刺时间≥15min是影响患者肺穿刺术后发生气胸的危险因素。
Objective To explore the diagnostic value of CT-guided lung needle biopsy for pulmonary nodules and risk factors of postoperative pneumothorax.Methods A total of 102 patients with pulmonary nodules were enrolled as the research objects between June 1,2018 and May 31,2021.All underwent CT-guided lung needle biopsy and MSCT.Taking clinical diagnosis results as the golden standard,diagnostic value of the two methods for pulmonary nodules by the two methods were compared.According to presence or absence of pneumothorax within 24h after surgery,they were divided into pneumothorax group and non-pneumothorax group.The risk factors of postoperative pneumothorax were analyzed.Results The consistency between CT-guided lung needle biopsy and clinical diagnosis results was greater than that between MSCT and clinical diagnosis results (Kappa:0.887 vs 0.598).AUC of CT-guided lung needle biopsy in the diagnosis of pulmonary nodules was greater than that of MSCT.According to presence or absence of pneumothorax,they were divided into pneumothorax group (n=27) and non-pneumothorax group (n=75).The proportions of cases with lesion depth ≥3cm,uneven lesion density,emphysema,pulmonary bullae and puncture time ≥15min in pneumothorax group were higher than those in non-pneumothorax group.The lesion depth ≥3cm,emphysema,pulmonary bullae and puncture time ≥15min were risk factor of pneumothorax after lung puncture.Conclusion The differential diagnosis value of CT-guided lung needle biopsy is high for benign and malignant pulmonary nodules.The lesion depth ≥3cm,emphysema,pulmonary bullae and puncture time ≥15min are risk factor of pneumothorax after lung puncture.
作者
王丽兵
王军
魏来
Wang Li-bing;Wang Jun;Wei Lai(Tianchang Hospital of Traditional Chinese Medicine,Respiratory Department,Tianchang 239300,China;Tianchang People's Hospital,Imaging Department,Tianchang 239300,China;Tianchxing Hospital of Traditional Chinese Medicine,Imaging Department,Tianchang 239300,China)
出处
《湖南师范大学学报（医学版）》
2022年第1期227-230,共4页
Journal of Hunan Normal University(Medical Sciences)
关键词
CT引导下肺穿刺活检术
肺小结节
诊断价值
术后并发症
气胸
危险因素
ct-guided lung needle biopsy
pulmonary nodule
diagnostic value
postoperative complication
pneumothorax
risk factor
