CT引导下经皮肺穿刺活检术对438例肺部肿块的临床诊断意义
发布时间：2018-09-03 15:00
【摘要】：目的 探讨CT引导下经皮肺穿刺活检在肺部肿块诊断中的意义及并发症防治措施,分析产生并发症的原因及主要影响因素,以提高CT引导下经皮穿刺肺活检术穿刺成功率。方法 对2015年1月至2016年6月住院且临床难以确诊的肺部肿物患者438例行CT引导下经皮肺穿刺活检术,并通过病理学确诊。结果 438例患者全部穿刺成功,穿刺成功率100.0%,一次穿刺阳性率94.9%,二次穿刺阳性率100.0%。438例病理诊断为恶性病变379例(86.5%),良性病变37例,不确定22例。经皮穿刺活检的敏感性、特异性、准确率分别为97.9%(376/384)、94.4%(51/54)、97.4%(427/438)。一次穿刺出现气胸33例(7.5%),痰中带血62例(14.2%),胸膜反应7例(1.6%),针道渗血6例(1.4%),未见针道种植。15例患者第二次穿刺出现气胸7例(46.6%),痰中带血1 1例(7 3.3%)。合并慢性阻塞性肺疾病(简称慢阻肺)、肺部病灶3 c m或穿刺深度≥5 c m的患者气胸和痰中带血发生率更高,差异有统计学意义(P0.05)。结论 CT引导下经皮肺穿刺活检术对肺部肿块具有良好的临床诊断价值,穿刺进针深、病灶小、有慢阻肺的患者穿刺并发症发生率越高。CT引导下经皮肺穿刺活检术是一种创伤相对小、确诊率高、安全性较好的方法。
[Abstract]:Objective to investigate the significance of percutaneous lung biopsy guided by CT in the diagnosis of pulmonary masses and the prevention and treatment of complications, and to analyze the causes and main influencing factors of complications in order to improve the success rate of percutaneous lung biopsy guided by CT. Methods from January 2015 to June 2016, 438 patients with pulmonary masses hospitalized from January 2015 to June 2016 were treated with percutaneous pulmonary biopsy guided by CT and confirmed by pathology. Results all the 438 patients were punctured successfully, the successful rate of puncture was 100.0%, the positive rate of primary puncture was 94.9, the positive rate of secondary puncture was 100.0.438 cases were diagnosed as malignant lesions in 379 cases (86.5%), benign lesions in 37 cases and uncertainty in 22 cases. The sensitivity, specificity and accuracy of percutaneous biopsy were 97.9% (376 / 384) and 94.4% (51 / 54) or 97.4% (427 / 438), respectively. There were 33 cases (7.5%) with pneumothorax, 62 cases (14.2%) with blood in sputum, 7 cases (1.6%) with pleural reaction, 6 cases (1.4%) with bleeding from needle canal, 7 cases (46.6%) with pneumothorax and 11 cases (73.3%) with blood in sputum. The incidence of pneumothorax and blood in sputum was higher in patients with chronic obstructive pulmonary disease (COPD), pulmonary focus 3 cm or puncture depth 鈮，
本文编号：2220319
[Abstract]:Objective to investigate the significance of percutaneous lung biopsy guided by CT in the diagnosis of pulmonary masses and the prevention and treatment of complications, and to analyze the causes and main influencing factors of complications in order to improve the success rate of percutaneous lung biopsy guided by CT. Methods from January 2015 to June 2016, 438 patients with pulmonary masses hospitalized from January 2015 to June 2016 were treated with percutaneous pulmonary biopsy guided by CT and confirmed by pathology. Results all the 438 patients were punctured successfully, the successful rate of puncture was 100.0%, the positive rate of primary puncture was 94.9, the positive rate of secondary puncture was 100.0.438 cases were diagnosed as malignant lesions in 379 cases (86.5%), benign lesions in 37 cases and uncertainty in 22 cases. The sensitivity, specificity and accuracy of percutaneous biopsy were 97.9% (376 / 384) and 94.4% (51 / 54) or 97.4% (427 / 438), respectively. There were 33 cases (7.5%) with pneumothorax, 62 cases (14.2%) with blood in sputum, 7 cases (1.6%) with pleural reaction, 6 cases (1.4%) with bleeding from needle canal, 7 cases (46.6%) with pneumothorax and 11 cases (73.3%) with blood in sputum. The incidence of pneumothorax and blood in sputum was higher in patients with chronic obstructive pulmonary disease (COPD), pulmonary focus 3 cm or puncture depth 鈮，
本文编号：2220319
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