CT引导下经皮肺穿刺活检术对周围型肺癌的诊断价值探究
投稿时间:2014-08-04  修订日期:2014-09-02  点此下载全文
引用本文:江明君.CT引导下经皮肺穿刺活检术对周围型肺癌的诊断价值探究[J].医学研究杂志,2015,44(3):131-134
DOI: 10.3969/j.issn.1673-548X.2015.03.037
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江明君 310022 杭州, 浙江省肿瘤医院 jmjun0707@163.com 
中文摘要:目的 探讨CT引导下经皮肺穿刺活检术诊断周围型肺癌的价值。方法 回顾性分析2009年1月~2014年6月期间在笔者医院放射科接受诊疗的625例患者的临床资料。对患者基本资料、穿刺成功率、病理诊断结果、肺穿刺活检并发症及相关危险因素进行统计分析。结果 本研究共有625例患者, 患者年龄39~86岁, 平均年龄62.71±10.18岁。其中, 男性416例, 女性109例。625例患者均CT引导肺穿刺确诊均为周围型肺癌。总的穿刺成功率为100%。625例患者病理类型以腺癌为主, 占78.40%, 腺鳞癌和鳞癌分别占9.28%和5.28%。本次研究625例患者肺穿刺活检主要并发症为气胸和咯血。病灶直径≤2cm、进针深度>3cm、穿刺针数≥3针、操作者经验不足(95%CI:2.217~19.281)等因素和并发气胸、咯血密切相关。合并COPD(95%CI:2.516~12.079)与并发气胸密切相关。结论 CT引导下经皮肺穿刺活检术用于周围型肺癌的诊断具有重要临床价值, 可提高诊断准确率。肺穿刺术中常见并发症有咯血和气胸, 与病灶直径、进针深度、穿刺针数、操作者经验、是否合并COPD等因素相关。
中文关键词:周围型肺癌  CT  经皮肺穿刺活检术  诊断价值
 
Value of CT Guided Percutaneous Lung Biopsy for the Diagnosis of Peripheral Lung Cancer
Abstract:Objective To study the value of CT guided percutaneous lung biopsy for the diagnosis of peripheral lung cancer. Methods During January 2009-June 2014 the clinical data of 630 patients accepting the diagnosis and treatment in department of radiology in our hospital were retrospectively analyzed. Basic information of the patients, the success rate of puncture, pathological diagnosis, lung biopsy complications and related risk factors were analyzed. Results This study included a total of 625 patients, aged 39-86, an average of 62.71±10.18 years old. Among them, 416 cases were male, 109 cases female. All 625 cases were diagnosed by CT guided lung biopsy as peripheral lung cancer. The general puncture success rate was 100%. Pathological type was given priority to 625 patients (78.40%) with adenocarcinoma.And glands squamous carcinoma and squamous cell carcinomas accounted for 9.28% and 5.28% respectively. The 625 cases of lung biopsy in patients with major complications were pneumothorax and hemoptysis. Focal diameter 2cm or less, the needle depth > 3cm, needle puncture needle number 3 or higher, the inexperienced operators (95% CI: 2.217-19.281), were closely related with pneumothorax, haemoptysis. Merger of COPD (95% CI: 2.516-12.079) was closely related to the pneumothorax. Conclusion CT guided percutaneous lung biopsy for the diagnosis of peripheral lung cancer has important clinical value, can improve the diagnostic accuracy. Lung puncture in the common complications is hemoptysis and pneumothorax, and were related to lesions in diameter, into the depth of the needle, needle number, the operator experience, whether merger of COPD.
keywords:Peripheral lung cancer  Computed tomography (CT)  Percutaneous lung biopsy  Diagnostic value
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