【摘要】 目的探讨CT引导下经皮肺穿刺组织病理学检查联合组织培养在肺部疾病中的诊断价值。方法对肺部阴影性质不明的患者进行完善的术前评估,共有48例接受CT引导下经皮肺穿刺活检的患者,其中16例行组织培养,分析肺穿刺活检组织病理联合组织培养的诊断阳性率及对临床的指导意义。结果 48例患者全部穿刺成功。其中恶性病变26例(54.2%),良性病变16例(33.3%),病理未能诊断6例,病理诊断阳性率87.5%。16例行组织培养,3例培养阳性,阳性率18.8%,其中良性病变的组织培养阳性率为30.0%。组织病理联合组织培养诊断率89.6%。结节组组织病理诊断率高于肿块组及片状影组,达95.0%,直径介于2 cm~3 cm的结节病理诊断率(100.0%)及直径介于3 cm~5 cm的肿物组织培养率(25.0%)高于其他组。术后气胸、出血发生率为14.6%。结论 CT引导下肺穿刺活检术是一项安全、有效的诊断方法。对于感染性病变,联合组织微生物培养能进一步提高确诊率。更多还原

【Abstract】 Objective To evaluate the diagnostic value of computer tomography( CT)-guided percutaneous lung biopsy and tissue culture in pulmonary diseases. Methods After the preoperative evaluation,48 patients underwent CT-guided percutaneous lung biopsy were analyzed,and 16 patients accepted tissue culture. The clinical significance of combined diagnostic rate of histopathology and tissue culture was investigated. Results All patients were punctured successfully. The pathological diagnosis confirmed 26( 54. 2%) cases with malignant lesions and 16( 33. 3%) cases with benign lesions. Six cases could not be pathological diagnosed. The pathological diagnostic rate was 87. 5%. Sixteen patients accepted tissue culture. Among them 3 cases with benign lesions were cultured. The positive rate of tissue culture was18. 8%,and improved to 30. 0% in the patients with benign lesion. The combined diagnostic rate of histopathology and tissue culture was 89. 6%. In addition,the accuracy rate of pathological diagnosis in the group of lung nodules was 95. 0%,higher than the others. The accuracy rate of pathological diagnosis in lung nodules of 2cm ~ 3cm in diameter was 100. 0%,and the positive rate of tissue culture in lung lump of 3cm ~5cm in diameter was 25. 0%. The incidence of pneumothorax and hemorrhage was 14. 6%. Conclusions CT-guided percutaneous lung biopsy is a safe and effective diagnostic method. For pulmonary infectious diseases,combination of CT-guided percutaneous lung biopsy and tissue culture can improve the early diagnostic rate.更多还原