CT引导下改良式活检枪在肺占位性病变穿刺活检中的应用价值

摘要

目的：探讨CT引导下改良式活检枪在肺占位性病变穿刺活检中的应用价值。方法 CT引导下对比分析改良式活检枪（Angiotech 21G）与传统活检枪（Angiotech 21G）在肺占位性病变中进行穿刺取材的体积的大小、活检阳性率、诊断准确率及并发症的发生率有无统计学差异。结果改良式活检枪与传统活检枪进行比较：穿刺成功率均为100％；取材体积（ mm3）均数±标准差分别为59．22±34．96、32．04±28．57，统计学分析差异有统计学意义（ Z ＝-7．32， P ＜0.01）；活检阳性率分别为98．88％、86．96％，统计学分析差异有统计学意义（ P ＝0．003＜0．05）；诊断准确率分别为97.75％、89．86％，统计学分析差异有统计学意义（ P ＝0．042＜0．05）；气胸发生率分别为8．99％、13．04％，统计学分析差异无统计学意义（ P ＝0．447＞0．05）；咯血及肺出血发生率分别为3．37％、14．49％，统计学分析差异有统计学意义（ P＝0．017＜0．05）。结论 CT引导下肺部占位性病变取材活检过程中，改良式活检枪较传统活检枪一次取材体积更多、活检阳性率更高、诊断准确率更高、气胸及肺出血咯血并发症发生率并不增加，临床上有很高的使用价值，值得推广使用。%Objective To evaluate the application value of modified biopsy gun in lung space-occupying lesions under the CT-guided percutaneous lung biopsy.Methods Under the guidance of CT, percutaneous lung biopsy was performed using modified biopsy gun and traditional biopsy gunin lung space-occupying lesions, respectively.Then, the size of the volume, biopsy positive rate and diagnostic accuracy rate and the incidence of complications were analyzed so as to see whether there existed statistically significant differences among those parameters.Results Comparing the modified biopsy gun with the traditional one, the results were as follows.The achievement ratio of puncture was all 100%;the size of the volume via the puncture, as presented as mean ±deviation, was 59.22 ±34.96 and 32.04 ±28.57, respectively, with statistically significant difference ( Z =-7.32, P <0.01).The biopsy positive rate was 98.88%and 86.96%, respectively, with statistically significant difference ( P =0.003<0.05).The accurate rate of diagnosis was 97.76% and89.86%, respectively, with statistically significant difference ( P =0.042<0.05) .The incidence of pneumothorax was 8.99%and13.04%, respectively, with no statistically significant difference ( P =0.447>0.05 ).The rate of hemoptysis and pulmonary hemorrhage was 3.37%and 14.49%, respectively, with statisti-cally significant difference ( P =0.017<0.05).Conclusion In the process of the biopsy for space-occupying lung lesions guided by CT, the modified biopsy gun can get much tissue than traditional one.This biopsy has higher positive rate and accurate rate for diagnosis.Meanwhile, the rates of pneumothorax, pulmonary hemorrhage or haemoptysis, as well as complications do not increase.Thus, the modified one has great value and is worthy of application in clinic.