【摘要】 目的:采用挂线法辅助微波针经皮癌性肺结节穿刺,对比徒手肺结节穿刺,评价其临床应用价值。方法:纳入河北医科大学第四医院和石家庄市中医院收治的孤立性癌性肺结节94例,CT轴状位肺结节长径平均(10.2±1.3)mm;实性肺结节45例,混合性磨玻璃结节38例,纯磨玻璃结节11例。肺结节距胸膜<1 cm 20例,1～5 cm 43例,>5 cm 31例。随机分为实验组和对照组,试验组采用挂线法辅助微波针经皮肺结节穿刺,对照组采用CT引导下徒手微波针经皮肺结节穿刺。穿刺过程中,出现退针或针尖插入肺结节周边区域,视为穿刺失败。记录两组穿刺成功率和(消融前)穿刺并发症。结果:试验组穿刺成功率91.3%,对照组71.7%(P<0.01)。试验组肺出血发生率13.0%,对照组21.7%(P<0.05)。试验组气胸发生率15.2%,对照组17.4%(P>0.05)。结论:挂线法辅助微波针肺结节穿刺可提高穿刺成功率,且方法简单、安全、成本低廉,是具有临床应用价值的新方法。更多还原

【Abstract】 Objective: To introduced the thread-hanging-assisted microwave antenna method for puncturing small malignant pulmonary nodules percutaneously and compared it with the freehand procedure, evaluating its clinical application value. Methods: A total of 94 cases with solitary malignant pulmonary nodules were enrolled in The Fourth Hospital of Hebei Medical University. The mean length of CT axial position of pulmonary nodules was(10.2±1.3) mm. There were 45 cases with solid pulmonary nodules, 38 with mixed groundglass nodules, and 11 with pure ground-glass nodules. The pleura-to-pulmonary nodule distance was <1 cm in 20 cases, 1–5 cm in 43 cases, and >5 cm in 31 cases. These cases were randomly assigned into 2 groups, the control group, including pulmonary nodules managed with CT-guided percutaneous freehand puncture with a microwave antenna, and the test group, including pulmonary nodules managed with thread-hanging assisted microwave antennae puncture method. If the needle tip was withdrawn or inserted into the periphery of the pulmonary nodule, the puncture was deemed to have failed; otherwise, it was considered successful. The success rate and complications of the puncture before ablation were recorded separately in the two groups. Results: The success rate of antenna puncture was 91.3% in the test group and 71.7% in the control group(P<0.01). The pulmonary hemorrhage rate was 13.0% in the test group and 21.7% in the control group(P<0.05). The pneumothorax rate was 15.2% in the test group and 17.4% in the control group(P>0.05). Conclusions: The thread-hanging method can improve the success rate of percutaneous puncture of malignant pulmonary nodules.This method is simple, safe, effective and inexpensive; therefore, it merits further evaluation.更多还原