CAJ | 학술논문

目的探讨CT导向下经皮肺穿刺活检(TNB)对儿童肺周围性病变的诊断价值及安全性.方法选择广州市妇女儿童医疗中心儿童医院8例肺周围性病变患儿,其中呼吸内科住院患儿7例,胸外科住院患儿1例.所有病例均采用自制标记物行CT扫描标记.在穿刺前对病灶行局部CT扫描,在静脉复合麻醉下,根据病灶部位、大小、穿刺入路及体位等选择穿刺平面、进针点和进针角度并计算合适的进针深度.将CT激光灯按选定层面投照于体表(横断面定位),使用黑色记号笔描记,将自制标记物贴于描记线上再次行CT扫描,选择符合要求的标记点(纵断面定位)作为穿刺点,由介入科医生使用活检针进行穿刺获取病变组织2～3条.固定后送病理学检查.结果术后未见咯血、气胸及肺内出血等并发症发生,无一例因CT导向下TNB死亡.8例患儿病理学检查结果显示,恶性肿瘤3例,良性肿瘤2例,肺结核2例,肺脓疡1例.结论 CT导向下TNB对明确儿童肺周围性病变的性质有较大帮助.
목적 탐토CT도향하경피폐천자활검(TNB)대인동폐주위성병변적진단개치급안전성.방법 선택엄주시부녀인동의료중심인동의원8례폐주위성병변환인,기중호흡내과주원환인7례,흉외과주원환인1례.소유병례균채용자제표기물행CT소묘표기.재천자전대병조행국부CT소묘,재정맥복합마취하,근거병조부위、대소、천자입로급체위등선택천자평면、진침점화진침각도병계산합괄적진침심도.장CT격광등안선정층면투조우체표(횡단면정위),사용흑색기호필묘기,장자제표기물첩우묘기선상재차행CT소묘,선택부합요구적표기점(종단면정위)작위천자점,유개입과의생사용활검침진행천자획취병변조직2～3조.고정후송병이학검사.결과 술후미견각혈、기흉급폐내출혈등병발증발생,무일례인CT도향하TNB사망.8례환인병이학검사결과현시,악성종류3례,량성종류2례,폐결핵2례,폐농양1례.결론 CT도향하TNB대명학인동폐주위성병변적성질유교대방조.
Objective To evaluate the clinical value and safety of CT-gnided percutaneous transthoracic needle biopsy in pediatric patients with pulmonary peripheral lesions. Methods 7 cases in respiratory department and 1 case in thoracic surgery were selected as research subjects, who were patients with pulmonary peripheral lesions. All of them were scanned by CT before puncture and intravenous combined anesthesia (propofol and ketamine) were implemented. The puncture point,angle and length were selected according to lesion location, size and posture. The body surface was irradiated by laser light of CT accordi ng toselected levels (cross-section location), marked with labels and scanned again. The operator selected the puncture point (vertical section location) up to the requirement, punctured with biopsy needle and obtained lesion tissues (2-3 strips) for pathological examination. Results Among 8 cases,3 were diagnosed malignant sarcomas, 2 benign tumors,2 pulmonary tuberculosis and 1 pulmonary abscess with pleural effusion. Hemoptysis, pneumothorax, or pulmonary hemorrhage was not seen. No complication or death was attributed to percutaneous transthoracie needle biopsy. All cases were diagnosed clearly. Conclusions CT-gnided transthoracie needle biopsy has great value for diagnosis of pediatric pulmonary peripheral lesions.