中华实验和临床感染病杂志（电子版）
中華實驗和臨床感染病雜誌（電子版）
중화실험화림상감염병잡지（전자판）
Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Version)
2015年
5期
674-677
,共4页
肺结核,疑似%活体组织检查%电子计算机体层扫描
肺結覈,疑似%活體組織檢查%電子計算機體層掃描
폐결핵,의사%활체조직검사%전자계산궤체층소묘
Suspected pulmonary tuberculosis%Biopsy in vivo%Computed tomography
目的 评价电子计算机X线断层扫描(CT)引导下经皮肺活检术对疑似肺结核的诊断价值及安全因素的探讨.方法 回顾性分析98例疑似肺结核患者在CT引导下行经皮肺活检术的临床资料,评价该手术对疑似肺结核的诊断价值及影响术后并发症发生率的因素.结果 98例疑似肺结核病例经CT引导经皮肺活检均获得病理学标本,其中经手术病理直接明确诊断肺结核68例,所有病例最终诊断为肺结核72例,占最终诊断率的94.4%.术后并发症气胸发生率为21.4%,引起气胸并发症的因素,在进针后调整方向是与否、肺气肿有与无、术中咳嗽有与无,年龄> 60岁与< 60岁、进针处经实变区域脏层胸膜是与否比较差异具有统计学意义(P均< 0.05).术后并发症咯血的发生率为9.2%,引起咯血并发症的因素,在进针后调整方向是与否、术中咳嗽有与无、病灶距脏层胸壁大于3 cm是与否、手术穿刺1次与2次或2次以上比较差异具有统计学意义(P均< 0.05).结论 CT引导下经皮肺切割活检术对疑似肺结核具有较高的诊断价值;进针部位、术中咳嗽、肺气肿及年龄因素影响气胸发生,咳嗽及病灶深度影响咯血的发生,其中穿刺次数及进针针尖方向调整对气胸和出血的发生均有影响.
目的 評價電子計算機X線斷層掃描(CT)引導下經皮肺活檢術對疑似肺結覈的診斷價值及安全因素的探討.方法 迴顧性分析98例疑似肺結覈患者在CT引導下行經皮肺活檢術的臨床資料,評價該手術對疑似肺結覈的診斷價值及影響術後併髮癥髮生率的因素.結果 98例疑似肺結覈病例經CT引導經皮肺活檢均穫得病理學標本,其中經手術病理直接明確診斷肺結覈68例,所有病例最終診斷為肺結覈72例,佔最終診斷率的94.4%.術後併髮癥氣胸髮生率為21.4%,引起氣胸併髮癥的因素,在進針後調整方嚮是與否、肺氣腫有與無、術中咳嗽有與無,年齡> 60歲與< 60歲、進針處經實變區域髒層胸膜是與否比較差異具有統計學意義(P均< 0.05).術後併髮癥咯血的髮生率為9.2%,引起咯血併髮癥的因素,在進針後調整方嚮是與否、術中咳嗽有與無、病竈距髒層胸壁大于3 cm是與否、手術穿刺1次與2次或2次以上比較差異具有統計學意義(P均< 0.05).結論 CT引導下經皮肺切割活檢術對疑似肺結覈具有較高的診斷價值;進針部位、術中咳嗽、肺氣腫及年齡因素影響氣胸髮生,咳嗽及病竈深度影響咯血的髮生,其中穿刺次數及進針針尖方嚮調整對氣胸和齣血的髮生均有影響.
목적 평개전자계산궤X선단층소묘(CT)인도하경피폐활검술대의사폐결핵적진단개치급안전인소적탐토.방법 회고성분석98례의사폐결핵환자재CT인도하행경피폐활검술적림상자료,평개해수술대의사폐결핵적진단개치급영향술후병발증발생솔적인소.결과 98례의사폐결핵병례경CT인도경피폐활검균획득병이학표본,기중경수술병리직접명학진단폐결핵68례,소유병례최종진단위폐결핵72례,점최종진단솔적94.4%.술후병발증기흉발생솔위21.4%,인기기흉병발증적인소,재진침후조정방향시여부、폐기종유여무、술중해수유여무,년령> 60세여< 60세、진침처경실변구역장층흉막시여부비교차이구유통계학의의(P균< 0.05).술후병발증각혈적발생솔위9.2%,인기각혈병발증적인소,재진침후조정방향시여부、술중해수유여무、병조거장층흉벽대우3 cm시여부、수술천자1차여2차혹2차이상비교차이구유통계학의의(P균< 0.05).결론 CT인도하경피폐절할활검술대의사폐결핵구유교고적진단개치;진침부위、술중해수、폐기종급년령인소영향기흉발생,해수급병조심도영향각혈적발생,기중천자차수급진침침첨방향조정대기흉화출혈적발생균유영향.
Objective To evaluate of CT guided percutaneous lung biopsy of suspected tuberculosis diagnostic value and safety factors.Methods Total of 98 cases with suspected tuberculosis who suffer lung biopsy under CT guidance were analyzed, retrospectively. The value of the operation of suspected tuberculosis and factors affecting the incidence of postoperative complications were evaluated.Results There were 98 cases with suspected tuberculosis by CT guided percutaneous lung biopsy for pathology specimen, which directly by surgery pathology tuberculosis diagnosis in 68 cases, all cases 72 cases diagnosed as tuberculosis, eventually account for 94.4% of the ifnal diagnosis rate. The incidence of postoperative complications were pneumothorax was 21.4%. Pneumothorax caused by the factors of complications. After the needle into the adjustment direction was or not, emphysema and with no intraoperatie cough and no older than 60 years of age and younger than age 60, into the needle in the area of consolidation of the pleura was dirty or not, with signiifcantly differences (P all < 0.05). The incidence of postoperative complications hemoptysis was 9.2%, the causes of hemoptysis complications. After the needle into the adjustment direction was or not, intraoperative cough and chest wall without, lesions from dirty layer which greater than 3 cm was 1 to 2 times or not, surgical biopsy or 2 or more times, with signiifcantly differences (P < 0.05).Conclusions CT guided percutaneous cutting biopsy of the lung to the diagnosis of suspected tuberculosis has a high value. Into the needle position, intraoperative cough, emphysema, and age factors affect pneumothorax occurs, cough and focal depth affect the incidence of haemoptysis, including number of puncture and into the direction of the needle tip all affect the adjustment of pneumothorax and bleeding.
