CT引导下经皮穿刺肺活检对肺门部结节的诊断价值
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The diagnostic value of CT⁃guided percutaneous lung biopsy for the nodules of lung hilum
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    摘要:

    目的:研究CT引导下经皮穿刺肺活检对肺门部不超过3.0 cm结节的诊断价值和安全性及可行性。方法:收集本院2016年7月—2020年2月纤维支气管镜检查阴性的肺门部结节患者行CT引导下穿刺肺活检的病例资料,记录病灶大小、病灶形态、穿刺径路长度、穿刺针进针角度、切割次数、有无肺气肿及并发症等情况并进行二元Logistic回归分析。结果:入组患者64例,均在CT引导下完成穿刺活检,其中腺癌29例、鳞癌14 例、小细胞肺癌 5例、特异性感染2例、混合性癌6例及转移癌1例,未能明确诊断病变7例。穿刺技术取材准确率为98.44%(63/64),灵敏度98.21%(55/56),假阴性率1.79%(1/56)。并发症主要为少量气胸及针道周围的出血灶,发生率分别为15.63%(10/64)、43.75%(28/64),穿刺径路长度为两种并发症发生共同影响因素,年龄和性别与气胸发生相关(P=0.035,P=0.003),切割次数及病灶形态与肺内出血的发生相关(P=0.019,P=0.009)。结论:CT引导下经皮穿刺肺活检对肺门结节的诊断准确率高,安全性较高,对临床诊疗具有较好的指导作用。

    Abstract:

    Objective:This study aims to investigate the diagnostic value,safety and feasibility of CT- guided percutaneous lung biopsy for hilar nodules less than 3.0 cm. Methods:The data of patients with the nodules of lung hilum without positive results from fibrobronchoscopy undergoing CT guided lung biopsy in our hospital from 2016,July to 2020,February were collected. The size and shape of the lesion,the length of the puncture path,the needle angle,cutting times and complications were recorded. Results:Total 62 patients were enrolled in the study. All cases were successfully conducted in the first biopsy including adenocarcinoma(n=29),squamous cell carcinoma(n=14), small cell lung cancer(n=4), specific infection(n=2), mixed cancer(n=6),metastatic cancer(n=1),and undetermined lesions(n=7). The accuracy rate,sensitivity and omission diagnostic rate was 98.44%(63/ 64),98.21 %(55/56)and 1.79%(1/56),respectively. The main complications were pneumothorax and pneumorrhagia,the incidence rates of which were 15.63%(10/64)and 43.75%(28/64),respectively. The length of the puncture path is important factor for two complications. The age and gender of patients are correlated with the incidence of pneumothorax. The cutting times and the shape of lesion are correlated with the incidence of pneumorrhagia. Conclusion:CT-guided percutaneous lung biopsy has higher diagnostic value and better safety for lung hilar nodules,playing a good guiding role in clinical diagnosis and treatment.

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王 芬,朱佳佳,张 伟,徐 海,张 腾,仲 艳,刘希胜,袁 梅,俞同福. CT引导下经皮穿刺肺活检对肺门部结节的诊断价值[J].南京医科大学学报(自然科学版),2021,(5):751-756

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  • 收稿日期:2021-01-17
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  • 在线发布日期: 2021-06-02
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