CAJ | 학술논문

目的介绍B超引导下经皮穿刺活检技术在小儿实体肿瘤中应用的体会.方法复旦大学附属儿科医院2009年5月至2010年5月期间,穿刺活检组17例,开腹活检组15例,分别就肿块部位,影像学特点,成功率,切口情况、病理,麻醉方式、手术时间、术后恢复情况、手术费用等方面进行回顾分析和比较.结果穿刺活检多见于腹膜后,而开腹活检在盆腔肿块应用较多.术前评估均无法Ⅰ期切除.两组均取到足够量的标本,获得明确的病理诊断,并与最终根治手术获得的病理一致.穿刺活检组无切口,而开腹活检组平均切口长(5.6±1.1) cm.穿刺活检组的麻醉和手术时间(32.0±7.3)min,明显低于开腹活检组(52.3±14.9) min (P=0.000)；术后恢复时间(7.1±4.3)h明显短于开腹活检组(75.2±12.3)h(P=0.000)；手术费用穿刺活检组(1021.2±113.2)元,明显低于开腹活检组(3047.2±237.6)元(P=0.000).结论穿刺活检具有操作简单、创伤小、时间短、费用低、出血少、感染风险低、恢复快的特点,一个穿刺点的多个方向的多次取材,可以保证标本量；B超引导下的活检更具有靶向性、准确性和安全性,值得应用和推广.
목적 개소B초인도하경피천자활검기술재소인실체종류중응용적체회.방법 복단대학부속인과의원2009년5월지2010년5월기간,천자활검조17례,개복활검조15례,분별취종괴부위,영상학특점,성공솔,절구정황、병리,마취방식、수술시간、술후회복정황、수술비용등방면진행회고분석화비교.결과 천자활검다견우복막후,이개복활검재분강종괴응용교다.술전평고균무법Ⅰ기절제.량조균취도족구량적표본,획득명학적병리진단,병여최종근치수술획득적병리일치.천자활검조무절구,이개복활검조평균절구장(5.6±1.1) cm.천자활검조적마취화수술시간(32.0±7.3)min,명현저우개복활검조(52.3±14.9) min (P=0.000)；술후회복시간(7.1±4.3)h명현단우개복활검조(75.2±12.3)h(P=0.000)；수술비용천자활검조(1021.2±113.2)원,명현저우개복활검조(3047.2±237.6)원(P=0.000).결론 천자활검구유조작간단、창상소、시간단、비용저、출혈소、감염풍험저、회복쾌적특점,일개천자점적다개방향적다차취재,가이보증표본량；B초인도하적활검경구유파향성、준학성화안전성,치득응용화추엄.
Objective To present the experience of ultrasound guiding subcutaneous puncture biopsy in diagnosis of chlidren's solid tumors.Methods From May 2009 to May 2010,32 patients who underwent tumor biopsy were recrnited in this study.Among them,17 underwent ultrasound guiding subcutaneous puncture biopsy,and the other 15 were performed open biopsy.The tumor location,size,image,achievement ratio,incision,pathology,anesthesia,operating time,complications and surgery cost were retrospectively analyzed and compared.Results Ultrasound guiding subcutaneous puncture biopsy was chosen for the patients with retroperitoneal tumor.And open biopsy was the indication for pelvic tumor.Preoperative evaluation suggested patients' tumor couldn't be completely removed by one stage surgery.Enough tissue volume was obtained by both of the 2 procedures.And postoperative pathological diagnosis was identical with the biopsy results.There was no incision on the patients with puncture biopsy,while the incision length in open biopsy group was 5.6 ±1.1 cm.The anesthesia and operation time of puncture biopsy were significantly shorter than those of open biopsy (32.0 ± 7.3 min vs 52.3 ± 14.9 ain,P =0.000).The postoperative recovery time of puncture biopsy was significantly shorter than that of open biopsy(7.1 ± 4.3 h vs 75.2 ± 12.3 h,P=0.000).The cost of puncture biopsy was significantly less than that of open biopsy ( 102l.2 ± 113.2 yuan vs 3047.2 ±237.6 yuan,P =0.000).Conclusions Simple,minimal invasive,short hospital stay,low cost,less bleeding,quick recovery are the obvious advantages of puncture biopsy.UItrasound guiding biopsy is accurate and safe to get enough tissue to make accurate diagnosis of solid tumor in children.