CT引导经皮肺穿刺活检临床应用体会
Journal of Diseases Monitor & Control(2013)
Abstract
目的 通过CT扫描精确定位引导下,获取病变组织标本(病变定性)及培养加药物敏感试验(其结果指导后续治疗),部分病例还可即时介入治疗.方法 根据病灶部位并结合患者的舒适程度选仰卧、俯卧及侧卧位,CT局部扫描后,确定穿刺点、穿刺角度及深度,用一次性穿刺活检套管针(16G~20G)穿入病灶内获取病灶组织标本送检.结果 166例患者中,穿刺后明确诊断162例.其中恶性肿瘤95例,结核53例,炎性假瘤2例,结核合并肺癌(鳞癌)3例,球形肺炎3例,坏死性肉芽肿1例,矽肺3例,恶性间皮瘤2例.穿刺活检阳性率为97.5%. 4例活检阴性者,4例活检阴性者,建议再次活检.本组病例并发2例少量气胸,1例大量气胸,速行胸腔闭式引流后好转.术中、后痰中带血3例,均未做特殊处理.结论 CT引导下经皮肺穿刺介入治疗术是一项安全、简单、痛苦小值得推广的技术,其特点是“微创”,对疾病的定性诊断,意义重大.
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Key words
tuberculous cavity,biopsy of pulmonary,percutaneous lung biopsy,interventional,intervention,anti-tuberculosis drug,CT guided needle,CT guided,therapy
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