CAJ | 학술논문

目的：分析老年人周围性肺肿块的超声图像特征以及超声引导下组织学活检的取材过程，探讨超声引导定位的安全性及风险预防，以提高超声引导下肺周围性肿块穿刺活检的成功率。方法：我院门诊及住院患者57例，其中男性43例，女性14例，年龄60-79岁，平均73.5岁。57例老年患者中合并慢性阻塞性肺病31例（占54%），合并心脑血管病49例（占86%），合并糖尿病等27例（占47%）。孤立性病灶48例，多发病灶9例。病灶>5cm 7例，3-5cm 21例，<3cm 29例。全程在超声实时监测引导下完成肺周围性肿块穿刺组织学活检。结果：全部病例取材过程顺利，标本满意，成功率100%。未出现并发症。病理分型鳞癌28例，腺癌19例，小细胞癌6例，鳞腺混合癌3例，未定型1例。结论：肺癌是常见的老年恶性肿瘤之一，随着社会人口的老龄化，老年肺癌发病率逐年增加。在超声引导下以微创的方式对老年患者肺部周围性肿块获取病理组织学诊断，是一种安全可靠的方法。老年患者本身基础疾病多，耐受性较差，存在器官老化基础功能减退等生理、病理方面的因素，本研究结果显示超声引导下定位准确，严格控制穿刺深度，组织切割精准无误，因而避免损伤周围组织结构，在超声引导下进行周围性肺肿块的穿刺活检，最显著的优势在于穿刺全过程均可直观的动态显示，术中可以在直视下准确把握进针角度、进针深度，确保对靶目标取材准确无误。克服了盲目性，避免了针下结构不清、并发症难以控制的缺点。提高了超声引导下肺周围性病变穿刺活检的成功率。为老年人平稳安全的完成肺肿块组织学穿刺活检及时进行诊断与治疗提供了重要依据。
목적：분석노년인주위성폐종괴적초성도상특정이급초성인도하조직학활검적취재과정，탐토초성인도정위적안전성급풍험예방，이제고초성인도하폐주위성종괴천자활검적성공솔。방법：아원문진급주원환자57례，기중남성43례，녀성14례，년령60-79세，평균73.5세。57례노년환자중합병만성조새성폐병31례（점54%），합병심뇌혈관병49례（점86%），합병당뇨병등27례（점47%）。고립성병조48례，다발병조9례。병조>5cm 7례，3-5cm 21례，<3cm 29례。전정재초성실시감측인도하완성폐주위성종괴천자조직학활검。결과：전부병례취재과정순리，표본만의，성공솔100%。미출현병발증。병리분형린암28례，선암19례，소세포암6례，린선혼합암3례，미정형1례。결론：폐암시상견적노년악성종류지일，수착사회인구적노령화，노년폐암발병솔축년증가。재초성인도하이미창적방식대노년환자폐부주위성종괴획취병리조직학진단，시일충안전가고적방법。노년환자본신기출질병다，내수성교차，존재기관노화기출공능감퇴등생리、병리방면적인소，본연구결과현시초성인도하정위준학，엄격공제천자심도，조직절할정준무오，인이피면손상주위조직결구，재초성인도하진행주위성폐종괴적천자활검，최현저적우세재우천자전과정균가직관적동태현시，술중가이재직시하준학파악진침각도、진침심도，학보대파목표취재준학무오。극복료맹목성，피면료침하결구불청、병발증난이공제적결점。제고료초성인도하폐주위성병변천자활검적성공솔。위노년인평은안전적완성폐종괴조직학천자활검급시진행진단여치료제공료중요의거。
Objective:To analyze the elderly in peripheral lung masses ultrasound image characteristics and ultra-sound guided biopsy tissue sampling process. Methods:All 57 patients were analyzed including 43 male,14 female, age 60-79 years old,average 73. 5. Of 57 cases of elderly patients,chronic obstructive pulmonary disease in 31 cases (54%). Combined with cardiovascular disease in 49 cases(86%). 27 cases were complicated with diabetes(47%), solitary lesion in 48 cases,9 cases with multiple lesions. Lesions >5cm 7 cases,3-5cm 21 cases,<3cm 29 cases below. Results:Samples were satisfactory,the success rate was 100% without complications. The pathological types:28 cases squamous cell carcinoma,19 cases adenocarcinoma,6 cases small cell carcinoma,mixed adeno squamous carcinoma in 3 cases,undifferentiated 1 case. Conclusion:The lung cancer is one of the most common malignant tumor in aged patients,with the aging of the population,elderly lung cancer incidence rate has increased year by year. Under the guidance of ultrasound in minimally invasive approach for elderly patients with peripheral lung mas-ses obtain histopathological diagnosis,is a safe and reliable method. The basis of the disease in elderly patients with itself,the tolerance of different organs function decline,aging based physiological,pathological factors,the results of this study indicate that ultrasound guided puncture positioning accuracy,strictly control the depth,tissue cutting ac-curate,so as to avoid damage to the surrounding tissue structure,ultrasound-guided biopsy of peripheral pulmonary masses the most significant advantage is dynamic,the whole process can intuitively display the puncture operation un-der direct vision,can accurately grasp the needle angle,the depth of the needle,ensure that the target material is ac-curate. Overcomes the blindness,avoids needle structure is not clear,difficult to control the disadvantages of compli-cations. To improve the ultrasound guided peripheral pulmonary lesions biopsy success rate. For the elderly,smooth and safe completion of lung tumor histology biopsy provides an important basis for timely diagnosis and treatment.