孤立性肺结节的诊断及治疗分析

目的探寻小结节的诊断方法。方法患者31例,年龄34-81岁,平均（58.2±2.1）岁,男18例,女13例,肺部单发、最大径不超过30 mm的结节影。所有病人均行螺旋CT发现结节,均完善纤维支气管镜检查,胸部CT增强,痰抗酸杆菌及痰脱落细胞检查。结果所有患者纤维支气管镜检查及痰结核涂片及脱落细胞检查均阴性。肺CT倾向于恶性肿瘤22例,良性9例,27例在该院或外院经肺穿刺或电视胸腔镜下活检,5例因年龄等原因未行活检者,到外院行PET检查均怀疑肺癌。以上肺部螺旋CT诊断恶性率为70.96%。结论对结节的性质进行正确地评价既可以使恶性结节的病人早期得到及时的手术治疗,又可以让良性结节的病人避免不必要的手术。

Analysis of the Diagnosis and Treatment of Solitary Pulmonary Nodules

Objective To explore diagnostic methods of small nodules. Methods 31 patients, includingl8 males and 13 females, with solitary pulmonary nodule of maximum diameter less than 30 mm, aged from 34 to 81（average 58.2~2.1 years old）, were given spiral CT examination, fiberoptic bronchoscopy examination, enhanced chest CT check, sputum examination for acid fast bacilli and exfoliated cytology. Results The results of fiber bronchoscopy examination and sputum tuberculosis smears of all patients were negative. The number of result of lung CT tending to malignant tumors were 22 cases, benign were 9 cases. 27 cases were given lung puncture or video-assisted thoracoscope biopsy in our hospital or other hospitals. 5 cases without biopsy for the reason of age did PET examination and were suspected of lung cancer. The diagnosis malignant rate of lung spiral CT exanimation of all the pa- tients was over 70.96%. Conclusion By correct evaluation of the nature of the nodules, patients with malignant nodules can re- ceive timely surgical treatment; patients with benign nodules can avoid unnecessary surgery.