退针芯法在MSCT引导下经皮肺穿刺活检肺门区15 mm≤直径≤30 mm小结节术中的应用

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摘要目的探讨退针芯法在MSCT引导下经皮肺穿刺活检肺门区小结节（15 mm≤直径≤30 mm）术中的价值。方法收集2010年1月～2016年5月我院的43例肺门区小结节（15 mm≤直径≤30 mm）患者作为研究对象，均经1～2次支气管镜检未能获得满意病理结果。将入选患者分为A组（16例）和B组（27例）。A组采用多次穿刺法获取标本，B组采用退针芯穿刺法获取标本。两组病例均采用自制体表定位栅，应用MSCT增强扫描MPR图模拟穿刺，找到安全活检路径；应用BARD半自动活检枪和18 G×200 mm穿刺活检针取两条组织标本，进行病理检查，分别统计两组活检术的手术时间、穿刺成功率、诊断阳性率、并发症发生率。结果 A组的平均手术时间为（58.80± 5.63）min，并发症发生率为50.00%，活检成功率为93.75%，诊断阳性率为87.75%；B组的平均手术时间为（33.42± 5.17）min，并发症发生率为18.51%，活检成功率为100.00%，诊断阳性率为96.29%，两组的手术时间、并发症发生率比较，差异有统计学意义（P＜0.05）。结论退针芯法在MSCT引导下经皮肺穿刺活检肺门区小结节（15 mm≤直径≤30 mm）术中能获得病理检查所需的组织标本，且比较安全，与多次穿刺法比较，缩短了穿刺手术时间、降低了并发症发生率，应用该穿刺技术患者临床获益明显。

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	崔华子
	陈爱林
	张守林

关键词 ：多层CT, 穿刺活检, 肺门小结节

Abstract：Objective To explore value of the retreat needle core method in MSCT guided percutaneous transthoracic needle biopsy in small nodules(15 mm≤diameter≤30 mm)operation of lung hilar region.Methods 43 lung hilar nodules(15 mm≤diameter≤30 mm)patients from January 2010 to May 2016 in our hospital were selected as study objects.All of the patients were not satisfied with pathological results by 1-2 bronchoscopy.All patients were divided into group A (16 cases)and group B (27 cases).Group A was used multiple puncture to get samples and group B was used retreat needle core puncture.Two groups of patients were treated with self-made surface positioning grid.MSCT enhanced scanning MPR image simulation puncture was used to find a safe biopsy path;BARD semi-automatic biopsy gun and 18 G×200 mm biopsy needle were used to collect two specimens and conduct pathological examination.The operation time,the success rate of puncture,diagnostic positive rate and the incidence rate of complication in the two groups were statistically analyzed.Results The average operation time,complication rate,the success rate of puncture and diagnostic positive rate in group A were respectively (58.80±5.63)min,50.00%,93.75%and 87.75%,which were respectively (33.42±5.17)min,18.51%,100.00%and 96.29%in group B.There was significant difference in the operation time and the incidence rate of complication between the two methods(P＜0.05).Conclusion The retreat needle core method in MSCT guided percutaneous transthoracic needle biopsy in small nodules(15 mm≤diameter≤30 mm)operation of lung hilar region can get the tissue specimens for pathological examination and is relatively safe.Compared with multiple puncture method,the average operation time is shortened and the complication rate reduces,patients can obtain significant clinical benefit by using this puncture technology.

Key words： Multi-slice computerized tomography Puncture biopsy Lung hilar small nodule

作者简介: 崔华子（1960-），男，本科，主治医师，专业：诊断及介入治疗

引用本文:

崔华子;陈爱林;张守林. 退针芯法在MSCT引导下经皮肺穿刺活检肺门区15 mm≤直径≤30 mm小结节术中的应用[J]. 中国当代医药, 2017, 24(9): 82-85.
CUI Hua-zi;CHEN Ai-lin;ZHANG Shou-lin. Application of the retreat needle core method in MSCT guided percutaneous transthoracic needle biopsy in small nodules(15 mm≤diameter≤30 mm) operation of lung hilar region. 中国当代医药, 2017, 24(9): 82-85.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2017/V24/I9/82

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