超声引导经皮穿刺活检在定性诊断肺周围型小结节的应用价值
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摘要
目的探讨超声引导经皮肺穿刺活检在定性诊断肺周围型小结节的应用价值与技巧分析。方法回顾性分析在我院行超声引导经皮肺穿刺活检术的肺周围型病变826例,根据病变最大径分为肺周围型小结节组(A组,直径≤3cm,239例)及非小病灶组(B组,直径>3cm,587例),比较两组穿刺诊断成功率和并发症的差异。结果 826例患者中,774例获得明确病理诊断,穿刺诊断成功率为93.70%(774/826),并发症发生率为9.08%(75/826)。A、B两组的穿刺诊断成功率分别为90.79%(217/239)、94.89%(557/587),A组穿刺诊断成功率低于B组,差异有统计学意义(χ~2=4.826,P<0.05)。两组患者的并发症比较,差异无统计学意义(χ~2=0.729,P>0.05)。结论超声引导下对肺周围型小结节穿刺活检具有微创、操作简单、安全、诊断性能较高等优点,需熟练掌握穿刺技巧,具有推广价值。
Objective To investigate the diagnostic value of ultrasound-guided transthoracic biopsy for small peripheral pulmonary nodules.Methods Eight hundred and twenty-six patients with peripheral pulmonary nodules which had undergone ultrasound-guided transthoracic biopsy in the First People′s Hospital of Foshan during were enrolled by analyzing diagnostic accuracy,complications of this procedure and times of puncture.Results Among all cases,seven hundred and seventy-four cases were confirmed by pathology.The diagnostic accuracy for small peripheral pulmonary nodules(Group A,diameter≤3 cm)was 90.79%(217/239),which is lower than the group of diameter>3 cm(Group B,557/587,94.89%)(χ~2=4.826,P<0.05).The factor of complications of this procedure had no differences between the two groups(χ~2=0.729,P>0.05).Conclusions Ultrasound-guided transthoracic biopsy appears to be a less invasive,simple,safe and effective method for diagnosing peripheral pulmonary nodules and can be recommended as an important diagnostic method in the patients with small peripheral pulmonary nodules abutting the chest wall.
Objective To investigate the diagnostic value of ultrasound-guided transthoracic biopsy for small peripheral pulmonary nodules.Methods Eight hundred and twenty-six patients with peripheral pulmonary nodules which had undergone ultrasound-guided transthoracic biopsy in the First People′s Hospital of Foshan during were enrolled by analyzing diagnostic accuracy,complications of this procedure and times of puncture.Results Among all cases,seven hundred and seventy-four cases were confirmed by pathology.The diagnostic accuracy for small peripheral pulmonary nodules(Group A,diameter≤3 cm)was 90.79%(217/239),which is lower than the group of diameter>3 cm(Group B,557/587,94.89%)(χ~2=4.826,P<0.05).The factor of complications of this procedure had no differences between the two groups(χ~2=0.729,P>0.05).Conclusions Ultrasound-guided transthoracic biopsy appears to be a less invasive,simple,safe and effective method for diagnosing peripheral pulmonary nodules and can be recommended as an important diagnostic method in the patients with small peripheral pulmonary nodules abutting the chest wall.
引文
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[7]袁莹萍,石德顺,黄伟俊,等.病变性质对超声引导下经皮肺穿刺活检术的影响[J].中国超声医学杂志,2018,34(5):418-420.
[8]梁瀛,沈宁.肺外周病变活检相关问题[J].中华结核和呼吸杂志,2016,39(2):158-159.
[2]张燕,章美武,范晓翔,等.超声引导下经皮肺穿刺活检术对周围型肺癌的诊断价值[J].中华超声影像学杂志,2014,23(12):1087-1088.
[3]HARRIS C L,TOLOZA E M,KLAPMAN J B,et al.Minimally invasive mediastinal staging of non-samll-cell lung cancer:Emphasis on ultrasonography-guided fine-needle aspiration[J].Cancer control:journal of the Moffitt Cancer Center,2014,21(1):15-20.
[4]杨慧慧,刘军杰,陈圆圆,等.超声引导下肺周围型病变穿刺活检成功率的影响因素分析[J].中国医学影像学杂志,2014,22(2):117-120.
[5]HASEGAWA M,SONE S,TAKASHIMA S,et al.Growth rate of small lung cancers detected on mass CT screening[J].Br J Radiol,2000,73(876):1252.
[6]方芹,黄伟俊,邱懿德,等.超声引导下肺外周型病变穿刺活检确诊率及并发症影响因素分析[J].中国超声医学杂志,2017,33(12):1084-1086.
[7]袁莹萍,石德顺,黄伟俊,等.病变性质对超声引导下经皮肺穿刺活检术的影响[J].中国超声医学杂志,2018,34(5):418-420.
[8]梁瀛,沈宁.肺外周病变活检相关问题[J].中华结核和呼吸杂志,2016,39(2):158-159.