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1、老年患者胸部病變CT引導(dǎo)下穿刺活檢臨床研究［摘要］目的探討老年人群胸部病變CT引導(dǎo)下穿刺活檢的價(jià)值和安全性。方法128例行CT穿刺活檢的老年胸部病變患者，含肺內(nèi)病變115例，縱隔病變8例，胸膜病變5例。CT掃描確定并引導(dǎo)穿刺途徑，達(dá)預(yù)定位置取材?；仡櫩偨Y(jié)分析其診斷正確率及并發(fā)癥發(fā)生率。結(jié)果128例老年患者的胸部病變中最終診斷惡性106例，良性22例,CT引導(dǎo)下穿刺活檢病理診斷的正確率為91.4%(117/128)o其中良、惡性病變的診斷正確率分別為75.0%(21/28)、90.6%(96/106),惡性病
2、變病理分型的診斷正確率為91.7%(77/84)o23例出現(xiàn)并發(fā)癥，總發(fā)生率為18.0%o包括氣胸17例(13.3%),皮下氣腫6例，縱隔氣腫1例，肺內(nèi)出血4例，發(fā)生率分別為13.3%、4.7%、0.8%、3.1%；無針道種植播散、肺扭轉(zhuǎn)及空氣栓塞等并發(fā)癥發(fā)生。2例氣胸患者需行閉式引流，其余患者無須特殊處理。結(jié)論CT引導(dǎo)下穿刺活檢術(shù)，在老年人群的胸部疾病中是一種安全、準(zhǔn)確、有效的診斷及鑒別診斷手段。［關(guān)鍵詞］胸部病變；活檢組織檢查；體層攝技術(shù)；X線計(jì)算機(jī)［中圖分類號(hào)］R446.8［文獻(xiàn)標(biāo)識(shí)碼］A［文章編號(hào)］
3、1673-9701(2009)23-08-04ClinicalAnalysisofCT-guidedBiopsyinElderlyPatientswithChestDiseaseZHENGXilDINGMingchaolCHENGGanglYANGMinghong21.DepartmentofRadiology,BeijingGeriatricsHospital,HaidianDistriet,Beijing100095,China；2.HubuHospital,Shandong262303,China[A
4、bstract]ObjectiveTostudythevalueandsafetyofCT-guidedpercutaneoustransthoracicbiopsyintheelderlywithchestdiseases?MethodsWeusedCT-guidedbiopsyfor128elderlypatientswithchestdiseases,ofwhich115casesoflungdisease,8casesofmediastinaldiseaseand5casesofpleuraldis
5、eases.ThewayofguidedpuncturewasdeterminedbyCTscanandwhentheneedlereachedthedesiredtarget,atissuespecimenwastaken.Thefinaldiagnosisneedtobeconfirmedbysurgery,andpathology.Thediagnosticaccuracyrateandtheincidenceofcomplicationswereanalyzed.Resultslnthe128eld
6、erlypatientswithchestdiseases,thefinaldiagnosisshowed106casesofmalignanttumorand22casesofbenign,withthecorrectdiagnosisrateofCT-guidedbiopsyas91.4%(117/128)?Thecorrectdiagnosisratesofbenignandmaligna.ntlesionswere75.0%(21/28),and90.6%(96/106),respectivelya
7、ndthediagnosticaccuracyforpathologicaltypingofthemalignantlesionswas91.7%(77/84).And23caseshadcomplications.Thetotalincidencewas18.0%,including17casesofpneumothorax(13.3%),6casesofsubcutaneousemphysema,1caseofmediastinalemphysemaand4casesofpulmonaryhemorrh
8、age,withtheincidenceof13.3%,4.7%,0.8%and3.1%,respectively.Nocomplicationslikereversepulmonaryandairembolismwerefound.Drainagewasrequiredfor2casesofpneumothorax,andtheremainingpatientsneedednospecialtreatment.
