肺结节的健康管理研究

目的 探索健康人群肺部结节良恶性的筛查方法及其健康管理.方法 回顾性分析2010年10月至2016年10月在西南医科大学附属中医医院健康管理中心.体检中心参加健康体检的128例体检者的肺部薄层CT扫描及病理结果 ,分为良性结节组和恶性结节组.分别对其结节大小、分叶征、毛刺征、血管集束征、胸膜凹陷征、空泡征、是否合并钙化、结节位置、发病年龄等因素进行对比分析.根据Mayo Clinic Model肺癌方程及SPSS统计学软件进行统计分析.结果两组病变直径、分叶、毛刺、血管集束征和胸膜凹陷征比较,差异有统计学意义(P<0.05);两组空泡征、发病年龄和肺癌生长部位(上肺)比较,差异无统计学意义(P>0.05).结论 孤立性肺结节越大,其恶性病变风险越高,分叶征、毛刺征、血管集束征、胸膜凹陷征均提示恶性可能,结节钙化提示良性可能.建议将肺部薄层CT扫描作为重点人群的常规体检项目,对肺部孤立结节者健康管理具有重要意义.

A Study on the Health Management of Pulmonary Nodule

Objective To explore the screening methods and health management of the benign and malignant pulmonary nodules in healthy people .Methods The results of the thin-slice CT scan of lung and pathological examination in 128 cases receiving physical examination from October of 2010 to October of 2016 in The Affiliated TCM Hospital of Southwest Medical University were analyzed retrospectively ,and those cases were divided into the benign group and the malignant group .The two groups were compared in terms of the factors including nodule size , lobulation sign , spiculation sign , vessel convergence sign , pleural indentation sign , vacuole sign , combined calcification ,nodule location and age of onset .Then the Mayo Clinic Model Equation of lung cancer and SPSS statistical software were used to perform the statistical analysis .Results There were significant differences between the two groups in the lesion diameter , lobulation sign , speculation sign , vessel convergence sign and pleural indentation sign (P<0.05 or P<0.01) and no significant differences in the vacuole sign ,age of onset ,and nodule location (P>0.05) .Conclusion The greater solitary pulmonary nodules means the higher risk of malignant lesions .The signs of lobulation ,spiculation ,vessel convergence and pleural indentation suggest the malignant possibility ,while the nodule calcification suggests the benign possibility .It is proposed that the thin-slice CT scan of lung be taken as the routine examination item of the high-risk population ,which is of great significance for the health management of patients with solitary pulmonary nodules .