CT引导下经皮肺穿刺活检术对肺部病变的诊治价值

目的探讨CT引导下经皮肺穿刺活检术对肺部病变的诊治价值。方法对98例肺部病变患者(局限性病灶89例,弥漫性病灶9例)进行研究。在CT引导下行经皮肺穿刺活检术,分别行组织学检查及细胞学涂片检查。以术后病理诊断为标准,分析经皮肺穿刺活检的成功率及病理学资料,观察气胸、咯血等并发症的发生率。利用此技术对6例患者进行穿刺植入放射性粒子进行治疗,观察其治疗效果及并发症等的发生率。结果穿刺后病理诊断为:98例肺部病变中恶性肿瘤81例占82.7%,良性病变13例占13.3%,无确定诊断4例占4.1%,穿刺成功率为95.9%(94/98)。穿刺并发症:除气胸8例,咯血3例外,无其它严重并发症。6例植入放射性粒子进行治疗的病例全部植入成功,成功率为100%(6/6),1例出现气胸,无其它严重并发症。结论CT引导下经皮肺穿刺活检术可为肺部病变的定性诊断提供可靠的细胞学、组织学和病原学依据;CT引导下经皮肺穿刺活检术确诊率高,并发症少;术者的操作及所选择的穿刺器材是阳性检出率的关键;此技术可为肺部病变的治疗提供一种新的途径。

The clinical value of the CT-guided percutaneous lung biopsy for diagnosis and treatment of lung diseases

【Objective】 To evaluate the CT-guided percutaneous lung biopsy for diagnosis and treatment of lung diseases.【Methods】 98 cases of lung diseases（89 cases of the limitations of lesions,nine cases of diffuse lesions） study.In CT guided percutaneous lung biopsy,respectively,histological examination line and cytology smears.Diagnosed as a pathological criteria,analysis of percutaneous lung biopsy and the pathology of the success rate of information,observation of pneumothorax,hemoptysis,such as the incidence of complications.Use this technology to patients with six cases of needle implants for treatment of radioactive particles,to observe the therapeutic effect and the incidence of complications.【Results】 The pathological diagnosis after puncture as follows： 98 cases of lung lesions in 81 cases of malignant tumors accounted for 82.7 percent,accounting for 13 cases of benign lesions and 13.3%,four cases of non-diagnosis 4.1%,puncture success rate of 95.9%（94/98）.Puncture complications： In addition to eight cases of pneumothorax,hemoptysis 3 exceptions,no other serious complications.6 cases of implantation of radioactive particles treated successfully implanted in all cases,the success rate was 100%（6 / 6）,1 patient had pneumothorax and no other serious complications.【Conclusion】 CT guided percutaneous lung biopsy for lung lesions and provide a reliable diagnosis of cytology,histology and etiology basis;CT-guided percutaneous lung biopsy confirmed a high rate with few complications;surgery the operation and Puncture the selected equipment is the key to positive rate;this technology for the treatment of lung disease to provide a new way.