论文部分内容阅读
目的：评价 Ｃ Ｔ 引导肺小结节经皮穿刺术的准确性、并发症及诊断价值。方法：选择１９９１ 年８ 月至１９９７ 年５ 月间行经皮肺穿刺术的１５８ 例患者中，病灶直径为０．５～２．０ ｃｍ 平均（１．７±０．４）ｃｍ 的３５ 例（３５ 个结节），共做了 ３８ 次穿刺，所采组织同时作细胞学和组织学检查。经手术者病理与穿刺结果对照，其余经临床随访而明确诊断。结果：３５ 例中癌 ２４ 例（原发支气管肺癌１９ 例，转移癌５ 例），穿刺阳性者共２１ 例，３ 例假阴性，无假阳性。穿刺确诊１１ 例良性病变，并经手术和随访证实。阳性和阴性预测值分别为１００％ 和７９％ 。共有５ 例（１３％ ）发生气胸，无１ 例经闭式引流或抽气处理。结论：肺小结节经皮肺穿刺术与较大结节或肿块穿刺比较同样具很高的敏感性，且临床价值更大，值得推广。
Objective: To evaluate the accuracy, complication and diagnostic value of CT-guided pulmonary nodules percutaneous puncture. Methods: From August 1991 to May 1997, 158 patients undergoing percutaneous pulmonary puncture were selected, and 35 cases (1.7 ± 0.4) cm in diameter of 0.5 ~ 2.0 cm 35 nodules). A total of 38 punctures were performed. The collected tissues were simultaneously subjected to cytological and histological examinations. After surgery and puncture the results of pathological control, the rest of the clinical follow-up and a clear diagnosis. Results: There were 24 cases of 35 cases of carcinoma (primary bronchial carcinoma in 19 cases and metastatic carcinoma in 5 cases). There were 21 cases with puncture positive, 3 cases with false negative and no false positive. Puncture confirmed 11 cases of benign lesions, and confirmed by surgery and follow-up. The positive and negative predictive values were 100% and 79% respectively. A total of 5 patients (13%) had pneumothorax, none of which were treated by closed drainage or aspiration. Conclusion: Pulmonary nodules percutaneous pulmonary puncture with larger nodules or mass puncture compared with the same high sensitivity and greater clinical value, it is worth promoting.