老年患者CT引导下肺穿刺活检的临床特点

目的评价老年患者行经CT引导下肺穿刺活检的必要性和安全性。方法回顾性分析某院2010年1月~2012年9月接受CT引导下经皮肺穿刺活检检查的588例患者的病例特点,将其分为≥65岁组202例和〈65岁组386例,对两组间发生气胸、咯血、发热并发症、肺部肿瘤诊断情况及住院时间进行统计分析。结果两组在气胸（P=0.5254）、咯血（P=0.4933）、发热（P=1.0000）并发症数和住院时间（P=0.1056）比较,差异无统计学意义,但在病理诊断肿瘤的比例上两组间差异有统计学意义（P〈0.0001）。结论胸部CT引导下肺穿刺活检这项检查对老年人的安全性同低年龄组相同。患者因此项检查发生并发症后不会增加住院时间。如果临床存在适应证,肺部占位的老年患者应积极选择此项检查来明确病理诊断,以提高肺部肿瘤的治疗率,改善患者的预后。

Clinical characterization of CT-guided fine needle aspiration biopsy of pulmonary lesions for elderly patients

Objective To evaluate the safety and necessity of CT-guided fine needle aspiration biopsy of pulmonary lesions in the elderly. Methods The study was conducted retrospectively on data between January 2010 and September 2012 at Chinese PLA General Hospital in Beijing. Six hundred and thirteen patients who had received the examination of CT-guided fine needle aspiration biopsy of pulmonary lesions were enrolled in the research. Patients were grouped as＂elderly＂（≥65 years） and ＂general＂（〈 65years） cases according to the age. Statistical analysis was made to evaluate the complications,hospital stay and neoplastic diagnosis of pathology in the two groups. Major complications associated with examination included： pneumothorax,hemoptysis and fever. Results When 202 cases of elderly group were compared with 386 cases of general group,the difference in pneumotborax （P= 0.5254）,hemoptysis （P=0.4933）,fever （P=l.0000）and the hospital stay （P=0.1056）were found to be of no statistic, al significance. However,there was significant difference in the diagnosis of neoplasms. Conclusions CT-guided fine needle aspiration biopsy of puhnonary lesions is a safe approach to the agers. The length of stay need not be extended in case of complications. With conclusive clinical indications,the aged people should be advised to use this examination to make a definite diagnosis of pathology because of the high incidence of neoplasms.