【摘要】 目的探讨同轴穿刺技术在肺结节的早期定性诊断中的应用价值及安全性。方法回顾分析2017年1—12月入住福建省肿瘤医院122例肺结节(≤3 cm)在CT引导下应用同轴穿刺技术进行经皮活检的病例,通过穿刺成功性率、并发症发生率以及相关影响因素分析评价该技术的有效性及安全性。结果 121例成功穿刺活检(99.18%),其中恶性肿瘤92例(76.0%);1例因气胸肺压缩>20%终止穿刺。122例中,11例并发气胸(9.02%);3例肺压缩>20%(2.5%),观察后自行吸收好转(未引流);14例并发出血(11.5%),其中咯血1例(0.8%),经止血处理后好转;无气体栓塞,随访2年未发生针道种植。肺结节穿刺后患者气胸与肺气肿和阻塞性肺炎相关(均P <0.05);穿刺后出血与肺气肿和肺结节大小相关(均P <0.05)。结论 CT引导下的同轴穿刺技术对肺结节早期定性诊断具有较高的应用价值且有较高的安全性。更多还原

【Abstract】 Objective To explore the application value and safety of CT-guided coaxial needle biopsy in the early qualitative diagnosis of pulmonary nodules. Methods A total of 122 patients with pulmonary nodules(≤3 cm) admitted to Fujian Provincial Cancer Hospital from January to December 2017 who underwent percutaneous biopsy with CT-guided coaxial needle biopsy were retrospectively analyzed. The efficacy and safety of this technique were evaluated through the analysis of puncture success rate, incidence of complications and related influencing factors. Results The puncture biopsy was successfully performed in 121 cases(99.18%), among them, 92 cases(75.4%) were malignant tumors, and the puncture was terminated in one case due to pneumothorax compression more than 20%. Among 122 cases,pneumothorax was found in 11 cases(9.02%). Three patients with lung compression more than 20%(2.5%) were improved by self-absorption after observation(without drainage). There were 14 cases of concurrent hemorrhage(11.5%), including one case(0.8%) of hemoptysis, which was improved after hemostasis treatment. There was no gas embolism and no needle implantation occurred in the follow-up period of two years. Pneumothorax was related to emphysema and obstructive pneumonia after pulmonary nodule puncture of patients(all P < 0.05). Hemorrhage after puncture was related to the size of emphysema and pulmonary nodules(all P < 0.05). Conclusion CT-guided coaxial needle biopsy has higher application value and safety in the early qualitative diagnosis of pulmonary nodules.更多还原