CT引导经皮肺穿刺活检诊断效果评估和并发症原因分析*

李凤1谢雪梅2徐洪涛2

(1.垫江县中医院放射科，重庆 垫江 408300；2.中国医科大学第一附属医院病理科， 辽宁 沈阳 110001)

【摘要】目的观察CT引导下经皮肺穿刺活检诊断的临床效果和并发症原因分析。方法收集行CT引导下经皮穿刺肺活检95例患者的临床资料,分析患者行CT引导经皮肺穿刺活检的诊断准确率与各种并发症。结果95例患者中诊断恶性肺部病变72例(75.8%)，准确率98.5%；良性病变23例(24.2%)，准确率91.3%。穿刺平均皮损面积21.4mm`2(范围8mm`2～78mm`2)，恶、良性患者并发血胸与气胸分别为5.6%、21.7%。Pearson 卡方检验显示，经肺损伤深度与肿瘤大小成负相关；良性肺病变患者的穿刺并发症发生率明显高于恶性病变组(χ`2=8.13，P=0.015)。结论CT引导下经皮穿刺肺活检术辅助诊断肺部恶性疾病准确率较高，然而在辅助肺部良性病变的诊断中因并发症较高应慎重应用。

【关键词】CT； 经皮； 穿刺； 肺； 诊断

【中图分类号】R 814.42

【文献标志码】A

doi：10.3969/j.issn.1672-3511.2015.10.039

Abstract【】ObjectiveTo explore diagnostic efficiency of CT-guided percutaneous puncturations for lung biopsies. MethodsClinical data of 95 patients underwent CT-guided lung biopsies were involved in the present study. There were 31 females and 64 males, aged from 13 to 78 years old, and the mean age was 59 years old. All the patients underwent CT-guided percutaneous puncturations for lung biopsies, and analyzed the diagnostic accuracies and complications. Results The biopsy samples for malignant and benign lesions were adequate in 75.8% and 24.2%, with the diagnostic accuracy of 93.2% and 95.5%, respectively. The mean lesion size was 21.4 mm`2 (range, 8 to 78 mm`2). The pneumothorax and haemoptysis occurred in 5.6% and 21.7% of malignant and benign lung lesions of patients, respectively. The results showed that it was significant higher of the incidence of complications in patients with benign lesions than the of malignant lesions in lung (χ`2=8.13，P=0.015). The traversed lung-length was negatively correlated with the tumor size of lung. ConclusionThe diagnostic efficiency of CT-guided percutaneous puncturations for lung biopsies is adequate for malignant lesions; however, more prudences must be paid when it is applying for the benign lesions.

基金项目：国家自然科学基金(81372497)

收稿日期：( 2014-07-01； 编辑： 陈舟贵)

DiagnosticefficiencyofCT-guidedpercutaneouspuncturationsforlungbiopsiesLIFeng1，XIE Xuemei2，XU Hongtao2

(1. Department of Radiology, Dianjiang TCM Hospital，Dianjiang 408300，Chongqing, China；

2.Department of Pathology，The First Affiliated Hospital and College of Basic Medical

Sciences, China Medical University，Shenyang 110001, China)

【Keywords】CT;Percutaneous;Puncturations;Lung;Diagnostic

近年来我国肺癌发病率逐步上升，其死亡率占城市人口恶性肿瘤的第一位。肺癌早期诊断直接影响着患者的预后，因而早期发现、诊断与治疗是降低其死亡率的重要方法[1]。肺癌早期筛查方法主要包括：影像学技术、纤维支气管镜、痰脱落细胞学检查、基因检测、血液肿瘤标志物检测等[2,3]。其中CT引导下经皮肺穿刺活检术能够准确地在病灶处取材、并进行病理诊断，是普遍接受的早期筛查肺癌的可行方法之一[4]。……