CT引导下中心型肺癌肺段支气管病变穿刺针吸活检

发布时间：2018-12-14 19:41

【摘要】：目的探讨CT引导下中心型肺癌肺段支气管病变穿刺针吸活检的价值,为制订治疗方案提供可靠的依据。资料与方法 55例疑似中心型肺癌肺段支气管病变患者行CT引导下穿刺针吸活检术采集病理组织标本,观察穿刺并发症情况,以及不同体位和穿刺针方向对并发症的影响。结果 55例患者均一次穿刺成功,并采集满意的组织活检标本,病理组织学明确诊断50例,确诊率为90.91%;其中手术病理或穿刺术后随访证实中心型肺癌肺段支气管病变阳性40例(72.73%),经穿刺术后随访证实中心型肺癌肺段支气管病变阴性10例(18.18%)。穿刺并发症:19例(34.55%)发生针道渗血,4例(7.27%)少量气胸,两者差异有统计学意义(χ2=6.03,P0.01)。俯卧位与仰卧位穿刺的并发症发生率差异无统计学意义(P0.05);垂直穿刺、水平穿刺、45°穿刺的并发症发生率依次降低(χ2=3.68,P0.05)。结论 CT引导下穿刺针吸活检在中心型肺癌肺段支气管病变中的病理诊断准确度较高,且无明显严重并发症,值得临床推广应用。
[Abstract]:Objective to investigate the value of needle aspiration biopsy of central lung cancer guided by CT. Materials and methods CT guided needle aspiration biopsy was performed in 55 patients with suspected central lung cancer lung segmental bronchiopathy. The complications of puncture were observed and the effects of different positions and directions of puncture needle on the complications were observed. Results all the 55 patients were successfully punctured at one time, and satisfactory biopsy specimens were collected, 50 cases were diagnosed by histopathology, the diagnostic rate was 90.91%. 40 cases (72.73%) were positive for pulmonary segmental bronchiopathy in central lung cancer and 10 cases (18.18%) were confirmed negative after puncture and follow up. Complications of puncture: blood leakage occurred in 19 cases (34.55%) and a small amount of pneumothorax in 4 cases (7.27%). The difference was statistically significant (蠂 ~ 2 = 6.03 卤P0.01). The incidence of complications in prone position and supine position was not significantly different (P0.05), while the incidence of complications in vertical puncture, horizontal puncture and 45 掳puncture was decreased in turn (蠂 2 3.68 P 0.05). Conclusion CT guided needle aspiration biopsy in central lung cancer is of high accuracy in the diagnosis of pulmonary segmental bronchiopathy, and there are no obvious serious complications, so it is worth popularizing in clinic.
【作者单位】：桂林市中医医院放射科;广西壮族自治区第二人民医院放射科;
【基金】：桂林市科学研究与技术开发计划资助项目(20120121-4-2)
【分类号】：R734.2;R730.44

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