经皮肺穿诊断肺癌的价值

目的　探索模拟机及CT导引经皮肺穿对肺部病灶定性诊断的价值。方法　 32 0例肺部病灶病人 ,模拟定位机导引经皮肺穿 2 90例 ,病灶 1cm× 2cm～ 10cm× 12cm ,周围型 2 6 5例 ;中央型 2 0例 ,两肺弥漫型 5例 ;CT定位经皮肺穿30例 ,病灶 1cm× 1cm～ 3cm× 4cm ;周围型 11例 ;中央型 19例。结果　 30 0例患者确诊为肺癌 ;15例为良性病变。模拟机及CT定位 :癌症确诊率分别为 93.8% (2 72 / 2 90 )和 93.3% (2 8/ 30 ) ;发现早期肺癌分别为 2例和 3例 ;肺部病灶的定性确诊率分别为 98.3% (2 85 / 2 90 )和 10 0 % (30 / 30 ) ;气胸发生率分别为 6 .6 % (19/ 2 90 )和 3.3% (1/ 30 ) ;穿刺后出血发生率分别为 16 6 % (4 8/ 2 90 )和 10 .0 % (3/ 30 )。结论　模拟机及CT导引经皮肺穿安全 ,准确、诊断迅速 ,对肺部病灶的定性诊断有重要意义 ,还可发现早期肺癌。

Transthoracic Needle Biopsy of Lung under Simulator and CT for the Diagnosis of Lung Carcinoma

Objective To investigate the value of simulator and CT guidingpercutaneous transthoracic for the diagnosis of pulmonary lesions. Method 320 patients with pulmonary lesions who received transthoracic needle biopsy were reported. 290 patients were received transthoracic needle biopsy of lung under simulator-guided. There were 265 patients with peripheral pulmonary lesions; 20 patients with central pulmonary lesions and 5 patients with bilateral pulmonary lesions, mass measure 1×2 cm～10×12 cm. 30 patients were received transthoracic fine needle biopsy of lung under CT-guided. There were 11 patients with peripheral pulmonary lesions; 19 patients with central pulmonary lesions Mass measure 1×1 cm～3×4 cm. Result 300 pulmonary lesions were proved to be malignant and 15 benign; To simulator and CT guiding percutaneous transthoracic, cancer diagnosis rate was 93.8%(272/290)and 93.3%(28/30), respectively. Major complications were pneumothorax and haemorrhage, the rate of which was 6.6% and 3.3%, 16.6% and 10.0%, respectively. Conclusion Simulator and CT guiding percutaneous transthoracic is safe and quick for diagnosis with high accuracy for pulmonary lesions. Percutaneous transthoracic should be widely used in the diagnosis of lung neoplasma.