目的 探讨如何针对不同病变选用不同的穿刺工具,以提高诊断正确率,降低术后并发症.方法 分别使用美国COOK DCHN抽吸针(16-18G,15 cm)及美国Angiotech半自动活检枪(16-18G,15 cm)对286例肺部病变进行经皮穿刺活检,其中使用抽吸针101例,使用半自动活检枪185例,依据手术病理判断活检病理诊断结果是否正确.比较选用抽吸针及半自动活检枪在诊断正确率和术后并发症发生率方面的差异.结果 选用抽吸针对恶性病变诊断正确率(89.3%)略高于半自动活检枪(80%);选用半自动活检枪对良性病变诊断正确率(93.7%)较抽吸针诊断正确率(41.2%)明显提高(P=0.002).选用半自动活检枪术后并发症(42.2%)略高于抽吸针(34.6%).结论 根据肺部病变的位置、大小、密度等因素,术前认真分析,合理选用不同的穿刺工具能够明显提高病变诊断正确率和减少术后并发症.%Objective To explore the suitable biopsy tools for different lesions for improving the diagnostic accuracy and reducing the postoperative complications. Methods The US COOK DCHN suction needle ( 16 to 18G,15 cm) and the US Angiotech semi-automatic biopsy gun ( 16 to 18G,15 cm ) were chosen to perform biopsies in 286 patients with lung lesions, including suction needle for 101 cases and semi-automatic biopsy gun for 185 cases. The biopsy results were compared with postoperative pathology diagnosis. The accuracy of diagnosis and postoperative complications were compared between suction needle and semi-automatic biopsy gun. Results The diagnostic accuracy for the malignant lesions was slightly higher by the suction needle than that by the semi-automatic biopsy gun ( 89. 3% vs 80% ). The diagnostic accuracy for benign lesions was obviously higher by semi-automatic biopsy gun than that by the suction needle ( 93. 7% vs 41. 2% , P = 0. 002 ). The incidence of postoperative complications was slightly higher by semi-automatic biopsy gun ( 42. 2% ) than that by the suction needle( 34. 6% ). Conclusion According to the location of the lesions in lung, size, density, to reasonably choose the suitable puncture tools can obviously improve the diagnostic accuracy and reduce the postoperative complications.
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