CT引导下经皮肺穿刺活检:18G和20G穿刺针的比较

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目的探讨应用18G、20G自动切割针行CT引导下经皮肺穿刺活检的诊断效率和并发症的差异。方法对比分析应用18G和20G自动切割针肺活检的2组各60例的诊断效率和并发症。结果18G组肺癌48例,穿刺确诊45例,确诊率93.8%,假阴性3例,假阴性率6.2%;良性病变12例,其中10例穿刺活检确诊。20G组肺癌46例,穿刺确诊42例,确诊率91.3%,假阴性4例,假阴性率8.7%;14例良性病变,其中10例穿刺活检确诊。18G组有20例发生气胸,2例需闭式引流处理,20G组有8例发生气胸,均是少量气胸,无需特殊处理。2组在确诊率、假阴性率、气胸发生率进行统计学处理,经χ2检验,P值>0.05,两者均无显著性差异。结论18G、20G2组在确诊率、假阴性率、气胸发生率均无显著差异,但18G组的气胸发生率及严重程度均高于20G组。 Objective To investigate the diagnostic efficiency and complications of CT guided percutaneous lung biopsy using 18G and 20G automatic cutting needles. Methods The diagnostic efficiency and complications of two groups of 60 cases with 18G and 20G automatic needle biopsy were compared and analyzed. Results In the 18G group, 48 cases of lung cancer were diagnosed by puncture and 45 cases were diagnosed by puncture. The diagnosis rate was 93.8%, the false negative rate was 3 and the false negative rate was 6.2%. The benign lesions were 12 cases, of which 10 were diagnosed by biopsy. In the 20G group, 46 cases of lung cancer were diagnosed by puncture and 42 cases were confirmed by puncture. The diagnosis rate was 91.3%, false negative rate was 4 and false negative rate was 8.7%. Among the 14 benign lesions, 10 were diagnosed by biopsy. There were 20 cases of pneumothorax in 18G group, 2 cases of closed pneumothorax, and 20 cases of pneumothorax in 8 cases. All of them were small pneumothorax without special treatment. There was no significant difference between the two groups in the diagnosis rate, false negative rate, pneumothorax incidence rate by χ2 test, P value> 0.05. Conclusion There was no significant difference in the diagnosis rate, false negative rate and pneumothorax between 18G and 20G2 groups, but the incidence and severity of pneumothorax in 18G group were higher than those in 20G group.
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