| 数显角度仪在CT引导经皮肺穿刺活检中的应用 |
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| 引用本文： | 李雪峰,何贵成,李诚,伍小平.数显角度仪在CT引导经皮肺穿刺活检中的应用[J].中国肿瘤临床,2019,46(9):457-461. |
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| 作者姓名： | 李雪峰 何贵成 李诚 伍小平 |
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| 作者单位： | 南华大学附属第一医院肿瘤内科（湖南省衡阳市421001） |
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| 基金项目： | 湖南省卫生计生委科研计划项目B2016132湖南省自然科学项目2019JJ50550国家自然科学基金青年科学基金项目81602443 |
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| 摘 要： | 目的 CT引导经皮肺穿刺活检对于肺小结节以及临近大血管的病灶具有难度。本研究旨在探讨数显角度仪在CT引导经皮肺穿刺活检中的应用价值。 方法 回顾性分析2018年1月至2018年9月南华大学附属第一医院经皮肺穿刺活检的35例患者。将患者分为A、B、C3组，A组与B组为病灶直径≤30 mm的肺结节，其中A组接受数显角度仪协助下的CT引导经皮肺穿刺活检，B组则在CT引导下徒手操作经皮肺穿刺活检。C组为病灶直径 > 30 mm肺部肿块，在CT引导下徒手操作经皮肺穿刺活检。然后比较3组之间穿刺前的肿块大小、进针次数、进针距离及术后血气胸并发症的差异。 结果 A组肺结节最大直径为（18.4±2.1）mm，显著小于B组（28.3±2.0）mm及C组（43.3±3.6）mm（P=0.003与P=0.003）。A组部分患者合并严重慢性阻塞性肺疾病（chronic obstructive pulmonary diseases，COPD）及病灶邻近大血管，且该组穿刺点至胸壁外侧距离也明显高于B组（P=0.039）。但A组一次性穿刺成功概率为100%，明显高于B、C组，同时该组术后并发症亦明显少于另外两组。 结论 经数显角度仪协助的CT引导下经皮肺穿刺活检术为一项安全、简便、准确的诊断方法，特别在肺小结节病变的患者中具有较好的应用价值。
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| 关 键 词： | 肺结节 肺癌 肺穿刺活检 数显角度仪 |
| 收稿时间： | 2019-01-16 |
Application of digital angle instrument in computed tomography-guided percutaneous lung biopsy |
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| Affiliation: | Department of Medical Oncology, The First Affiliated Hospital, University of South China, Hengyang 421001, China |
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| Abstract: | Objective Computed tomography (CT)-guided percutaneous lung biopsy is difficult for small nodules and lesions that are adjacent to large blood vessels. This study investigated the validity of CT-guided percutaneous lung biopsy in the diagnosis of pulmonary nodules with a digital angle instrument. Methods This study was a retrospective analysis of 35 patients with lung mass ≤60 mm, who underwent CT- guided percutaneous lung biopsy from January 2018 to September 2018. Patients were assigned in to three groups. Group A and B were patients with pulmonary nodules ≤30 mm. Biopsy of group A was performed with the help of a digital angle instrument, and group B didn' t use digital angle instrument. Group C had lung mass of > 30 mm, and the biopsy was performed without using the instrument. The size of the mass, frequency of punctures, distance of the puncture, and complication of pneumothorax after puncture were compared among the three groups. Results The maximum diameter of pulmonary nodules in group A (18.4 ± 2.1) mm was significantly lower than that in groups B (28.3 ± 2.0) mm and C (43.2 ± 3.6) mm, and their P value were 0.0034 and 0.0028, respectively. Some patients in group A were at risk because of severe chronic obstructive pulmonary disease and proximity of lesions to large blood vessels. The puncture distance in group A was also significantly more than groups B (P < 0.039). However, the probability of puncture success in group A was 100%, which was significantly higher than groups B and C. The postoperative complications in group A were also significantly fewer than in other two groups. Conclusions CT-guided percutaneous lung biopsy with a digital angle instrument is a safe, simple, and accurate diagnostic method, especially in patients with pulmonary nodular lesions. |
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