超声引导穿刺活检对中心型肺肿瘤的诊断价值

目的：对其他检查方法不能作出定性诊断的中心型肺肿瘤进行超声引导穿刺活检，探讨该方法对中心型肺肿瘤的诊断价值。方法：通过实变肺行超声检查确认肿瘤，并设定穿刺线路。采用21G日产八光手动负压穿刺针摄取组织，3．0cm以上的肿瘤同时加用美国Bard自动活检枪及21G细针活检，针腔内残留液均做细胞学检查，结果：52例接受穿刺者组织学检查诊断正确率为71．2％（37例），细胞学检查诊断正确率为69．2％（36例），二种方法互补诊断正确率达84．6％（44例），组织定性诊断率达80．8％（42例），并发症7例（13．5％），其中气胸2例，咳血痰5例（10％），无严重并发症发生。结论：超声引导细针穿刺活检对肺中心型肿瘤的定性诊断，为确定治疗方案提供了依据，有较高临床应用价值，但中心型小肿瘤的超声显示和确认仍为穿刺活检的首要条件,应予以重视。

The value of ultrasound-guided biopsy in diagnosis of central pulmonary cancer

Objective To evaluate the value of ultrasound guided biopsy in diagnosing of those central pulmonary lesions that can't be diagnosed by other examinations.Methods Indentify the tumors in the consolidated lung using ultrasound,and determine the routine of guidance.Perform fine needle biopsy to obtain tissue firstly with 21 gauge needle which contains an outer sheath and an inner stylet (Blakko,Japan).And when the diameter of tumor was larger than 3.0 cm,true cut needles(Bard,American) for biopsy was added to get adequate tissue.The aspiration materials and the remain materials in the true cut needle all underwent a cytologic examination.Results Fifty two cases were included.The accuracy of histologic examination was 71.2% (37 cases),and the accuracy of cytologic examination was 69.2% (36 cases).When these two methods were combined,the accuracy was up to 84.6% (44 cases),and 42 cases( 80.8% ) qot the right pathologic classification.Complications appeared in 7 cases( 13.5% ) including 2 cases pneumothorax,and 5 cases hemoptysis.No serious complication occurred.Conclusions Differentiating diagnosis of the central pulmonary tumors with ultrasound guided biopsy can provide evidences for the clinics to make therapeutic plans,the method definitely has important clinical values.But the princeps factor of ultrasound guided biopsy is the revealing and identifying of the small central tumor,which should be attached importonce to.