CT引导下肺肿块穿刺抽吸术与活检术应用比较.doc

CT引导下肺肿块穿刺抽吸术与活检术的应用比较 　　[摘要] 目的 对比研究CT引导下肺肿块穿刺抽吸术与活检术对肺部肿块的诊断率及不良反应。 方法 回顾性分析2010年1月～2014年5月于上海交通大学医学院附属新华医院崇明分院行CT引导下肺肿块穿刺术的147例患者的临床资料。按穿刺手术方式的不同，分为抽吸术组（82例）及活检术组（65例）。比较两组患者的疾病穿刺成功率、病理诊断率、病理分类诊断率及不良反应发生情况。 结果 抽吸术组与活检术组穿刺成功率分别为96.34%、92.65%；病理诊断率分别为81.71%、89.23%；病理分类诊断率分别为39.02%、89.23%；活检术组的病理诊断率高于抽吸术组，穿刺成功率低于抽吸组，但差异无统计学意义（P 0.05），活检术组的病理分类诊断率明显高于抽吸术组，且差异有统计学意义（P 0.05）。 结论 CT引导下肺肿块穿刺抽吸术与活检术均是安全有效的检查方法，但活检术更有利于现阶段肿瘤治疗对病理诊断的要求 [关键词] CT 引导；经皮肺穿刺；活检；病理学 [中图分类号] R734.2 [文献标识码] A [文章编号] 1673-7210（2016）07（b）-0096-03 [Abstract] Objective To explore the diagnostic rate and adverse reactions of CT-guided hematoma aspiration and biopsy in diagnosis of pulmonary tumor. Methods Clinical data of 147 patients receiving CT-guided lung biopsies in Chongming Branch of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2010 to May 2014 were retrospectively analyzed. All the patients were divided into aspiration group （82 cases） and biopsy group （65 cases）， the diagnostic rate， pathological diagnosis rate and adverse reactions of patients were compared between the two groups. Results The puncture success rate in the aspiration group and biopsy group were 96.34%， 92.65%， the pathologic diagnostic rates were 81.71%， 89.23%. The pathologic diagnosis rate was higher than that of the aspiration group and the puncture success rate was lower than that of the aspiration group， but the differences between the two groups were not significant （P 0.05）. The pathological diagnosis rate in the biopsy group was higher than that of the aspiration group （P 0.05）. Conclusion CT-guided hematoma aspiration and biopsy in diagnosis of pulmonary tumor are safe and effective methods， but biopsy is more favorable for the diagnosis of pathological diagnosis for tumor treatment at present stage. [Key words] CT guidance； Hematoma aspiration； Biopsy； Pathobiology 肺癌是目前中国发病率最高的恶性肿瘤[1]，而CT引导下肺肿块穿刺抽吸术与活检术是临床上常用的获取细胞及组织从而进行病理诊断的方法。CT引导下肺肿块穿刺抽吸术与活检术都具有操作简单、创伤