摘要
目的:评估综合使用经电子支气管镜肺活检和CT引导下经皮肺穿刺活检经皮肺穿刺活检对疑为周围性肺癌的肺外周孤立性肿块的诊断价值,评估其安全性。方法:对136例经无创检查未能确诊的肺外周孤立性肿块患者,根据病变部位、距胸膜距离及患者病情,对其中62例患者进行了经电子支气管镜肺活检,对另外74例患者使用精细针进行了经皮肺穿刺活检。评估各自诊断准确率、恶性病变诊断敏感度、并发症发生率。结果:经电子支气管镜肺活检和经皮肺穿刺活检均能获取组织标本。病理结果显示经电子支气管镜肺活检组有29例为恶性病变,6例为良性病变,27例无明确病理诊断结果,诊断准确率为71%;恶性病变诊断敏感度为69.0%;经皮肺穿刺活检组有59例恶性病变,7例为良性病变,8例无明确病理诊断结果,诊断准确率为94.6%;恶性病变诊断敏感度为95.2%(P<0.01)。两组均未出现严重并发症,经电子支气管镜肺活检并发气胸1例,痰中带血10例。经皮肺穿刺活检组并发气胸11例,痰中带血1例,肺内出血4例。结论:综合使用经电子支气管镜肺活检、经皮肺穿刺活检对疑为周围性肺癌的肺外周孤立性肿块的诊断具有重要价值,安全性高。
Objective To evaluate the application of the electronic bronchoscopy-guided transbronchial lung biopsy and CT-guided percutaneous needle lung biopsy in the diagnosis of solitary peripheral pulmonary nodules or masses. Methods One hundred and thirty-six patients with peripheral solitary lung nodules or masses were not diagnosed with noninvasive examination, in which 62 patients were selected with transbronchial lung biopsy and 74 patients with percutaneous needle lung biopsy according to the different lesion location on CT. The correct diagnosis rates, the sensitivity of malignant tumor and complication rates were identified in these cases. Results The success rate for obtaining a specimen was 100% in two groups. The correct diagnosis rate was 71% in transbronchial lung biopsy group, and 94. 6% in percutaneous needle lung biopsy group, respectively. The sensitivity of malignant tumor was 69% in transbronchial lung biopsy, and 95. 2% in percutaneous needle lung biopsy group. No serious complication occurred in all cases after biopsy. Pneumothorax occurred in 1 case of transbronchial lung biopsy group, and in 11 cases of percutaneous needle lung biopsy group, respectively. Hemoptysis occurred in 10 cases of transbronchial lung biopsy, and in 1 case in percutaneous needle lung biopsy. Intrapulmonary hemorrhage occurred in 4 cases of percutaneous needle lung biopsy group, and no intrapulmonary hemorrhage occurred in transbronchial lung biopsy group. Conclusion Both transbronchial lung biopsy and percutaneous needle lung biopsy are valuable diagnostic methods for peripheral solitary pulmonary nodules or masses, fitting different lesions. The comprehensive application can increase the accuracy and security.
出处
《实用诊断与治疗杂志》
2007年第5期351-353,共3页
Journal of Practical Diagnosis and Therapy
关键词
肺外周围孤立性肿块
经皮肺活检
经支气管镜肺活检
Peripheral solitary lung nodules or masses
percutaneous needle lung biopsy
transbronehial lung biopsy group
