国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2012年
9期
1220-1222
,共3页
陈志宏%胡丽珍%郑意梅%李德宪
陳誌宏%鬍麗珍%鄭意梅%李德憲
진지굉%호려진%정의매%리덕헌
肺周围型病变%经皮肺活检%经支气管镜肺活检
肺週圍型病變%經皮肺活檢%經支氣管鏡肺活檢
폐주위형병변%경피폐활검%경지기관경폐활검
Peripheral lung lesions%Transthoracic needle lung biopsy%Transbronchoscopic lung biopsy
目的 通过比较CT引导下经皮肺穿刺(TNLB)及经电子支气管镜肺活检(TBLB)对肺周围型病变的确诊率及并发症的发生情况,探讨2种活检方式在临床诊断工作中的价值.方法 近5年广州市胸科医院经影像学诊断为肺周围型病变查因的患者249例,按照肺活检方式分为经皮肺穿刺肺活检组(TNLB组)153例和经支气管镜肺活检组(TBLB组)96例,比较比较2种活检方法确诊率及各种并发症发生率.结果 TNLB组确诊率(77.8％)明显高于TBLB组(45.8％);并发症方面:气胸发生率两组相似,肺出血发生率TBLB组(53.1％)明显高于TNLB组(7.2％),但在30 ml以上的出血,两组无统计学差异；TBLB组血氧饱和度下降及心动过速的发生率明显高于TNLB组.结论 2种活检方法都是创伤小、安全性较高的检查手段,在临床上的使用各有优劣,有些情况下能形成互补,结合起来有助于提高肺周围型病变确诊率.
目的 通過比較CT引導下經皮肺穿刺(TNLB)及經電子支氣管鏡肺活檢(TBLB)對肺週圍型病變的確診率及併髮癥的髮生情況,探討2種活檢方式在臨床診斷工作中的價值.方法 近5年廣州市胸科醫院經影像學診斷為肺週圍型病變查因的患者249例,按照肺活檢方式分為經皮肺穿刺肺活檢組(TNLB組)153例和經支氣管鏡肺活檢組(TBLB組)96例,比較比較2種活檢方法確診率及各種併髮癥髮生率.結果 TNLB組確診率(77.8％)明顯高于TBLB組(45.8％);併髮癥方麵:氣胸髮生率兩組相似,肺齣血髮生率TBLB組(53.1％)明顯高于TNLB組(7.2％),但在30 ml以上的齣血,兩組無統計學差異；TBLB組血氧飽和度下降及心動過速的髮生率明顯高于TNLB組.結論 2種活檢方法都是創傷小、安全性較高的檢查手段,在臨床上的使用各有優劣,有些情況下能形成互補,結閤起來有助于提高肺週圍型病變確診率.
목적 통과비교CT인도하경피폐천자(TNLB)급경전자지기관경폐활검(TBLB)대폐주위형병변적학진솔급병발증적발생정황,탐토2충활검방식재림상진단공작중적개치.방법 근5년엄주시흉과의원경영상학진단위폐주위형병변사인적환자249례,안조폐활검방식분위경피폐천자폐활검조(TNLB조)153례화경지기관경폐활검조(TBLB조)96례,비교비교2충활검방법학진솔급각충병발증발생솔.결과 TNLB조학진솔(77.8％)명현고우TBLB조(45.8％);병발증방면:기흉발생솔량조상사,폐출혈발생솔TBLB조(53.1％)명현고우TNLB조(7.2％),단재30 ml이상적출혈,량조무통계학차이；TBLB조혈양포화도하강급심동과속적발생솔명현고우TNLB조.결론 2충활검방법도시창상소、안전성교고적검사수단,재림상상적사용각유우렬,유사정황하능형성호보,결합기래유조우제고폐주위형병변학진솔.
Objective To explore the values of CT-guided transthoracic needle lung biopsy ( TNLB ) and transbronchoscopic lung biopsy ( TBLB )in the clinical diagnosis by comparing the identification rates of both procedrues for peripheral lung lesions and the incidence rates of procedure-related complications.Methods 249 patients with peripheral lung lesions on radiographic examinations were divided into TNLB group( 153 patients ) and TBLB group ( 96 patients ) based on the method for lung biosy.The rate of lesion identification and the incidence rate of complications were compared between the two groups.Results The rate of lesion identification was markedly higher in TNLB group than in TBLB group ( 77.8％ vs.45.8％ ).The incidence of pneumothorax was similar in the two groups.The incidence of pulmonary hemorrhage was significantly higher in TBLB group than in TNLB group ( 53.1％ vs.7.2％ ),but the rate of bleeding volume of 30 ml or more did not differ significantly between the two groups.The incidence rates of tachycardia and decreased SaO2 were evidently higher in TBLB group than in TNLB group.Conlusions Both biopsies is a less invasive,safer procudure and have their own advantages and disadvantages.Combination of the two procedures is beneficial for the improvement of the identification rate of peripheral lung lesions.
