CT引导下肺穿刺活检对肺周围结节的诊断价值
The Clinical Diagnostic Significance Of CT-Guided Percutaneous Transthoracic Lung Biopsy for Diagnosis Of Peripheral Pulmonary Nodules

黄海.CT引导下肺穿刺活检对肺周围结节的诊断价值[J].内科急危重症杂志,2016,22(5):

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英文关键词:CT-guided Percutaneous transthoracic lung biopsy Peripheral pulmonary nodules Diagnosis

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作者	单位	E-mail
黄海	湖北省恩施土家族苗族自治州中心医院	eshuanghai@163.com

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中文摘要:

目的探讨CT引导下经皮肺穿刺活检术对肺周围结节诊断的临床价值。方法对2010年1月-2015年12月期间在本院172例肺周围结节住院患者在CT引导下经皮肺穿刺活获取组织标本行病理学、细胞学及细菌学检查。结果本组研究共获得172病例标本，包括男性108例，女性63例，年龄21～83岁,平均年46.7龄岁。172例CT引导下经皮肺穿刺活检诊断为肺癌105例（腺癌61例、鳞癌32例、小细胞癌7例、未分型肺癌5例）、炎性假瘤32例、结核球22例、肺脓肿7例、霉菌球2例、机化性肺炎2例、正常肺组织2例。其中26例诊断为肺癌的患者经手术切除（腺癌17例、鳞癌9例）与穿刺病理结果相符。穿刺后并发症气胸8例（4.65%），咯血28例（16.27%）、其中大咯血2例（1.16%）。结论 CT引导下经皮肺穿刺活检术在肺周围结节的诊断中阳性率高，相对安全，具有较高临床诊断及应用价值。

英文摘要:

Abstract Objective: To evaluate the efficacy and safety of CT-guided percutaneous transthoracic lung biopsy in patients with peripheral pulmonary nodules. Methods: From January 2010 to December 2015, 172 hospitalized patients with peripheral pulmonary nodules were tested by CT-guided percutaneous transthoracic lung biopsy, and the obtained Specimens were submitted for pathological histological, cytological and bacteriological examination. Results: Of the study, 172 cases of patients with peripheral pulmonary nodules were recruited, including 108 males and 63 females ranging from 21 to 83 years with an average age of 46.7 years. Among them, 170 patients were clinically diagnosed as positive(98.8%), and the other 2 cases were normal(1.2%). Pathological classifications results were as follows: 105 cases lung cancer (61 cases of adenocarcinoma, 32 cases squamous cell carcinoma, 7 cases small cell carcinoma, and 5 cases of bronchogenic carcinoma）, 32 cases of inflammatory pseudotumor, 22 cases of tuberculoma, 7 cases of lung abscess, 2 cases of fungal ball, 2 cases of pneumonia . The main complications of CT-guided percutaneous transthoracic lung biopsy were pneumothorax(n=8, 4.65%) and hemoptysis(n=30, 17.43%). Of the 105 lung cancer patients, 26 patients underwent surgical resection, and the pathologic findings(17 cases of adenocarcinoma and 9 cases of squamous cell carcinoma) were consistent with the pathologic findings. Conclution: CT-guided percutaneous transthoracic lung biopsy is both safe and effective in the diagnosis of peripheral pulmonary nodules. It's worthy of clinic application and promotion for it’s high diagnostic value in lung cancer.