改良中心静脉导管辅助超声引导胸膜活检术临床探究.docVIP

改良中心静脉导管辅助超声引导胸膜活检术临床探究【摘要】 目的 观察改良中心静脉导管辅助超声引导胸膜活检术在胸膜病变的阳性率和安全性。方法 对我院自2006~2010年诊断为胸膜疾病并行针刺胸膜活检102例患者的临床资料进行回顾性分析。结果 102例胸膜活检中提示结核性胸膜炎34例(30.8％)、慢性炎症18例(20.8％)、腺癌21例(18.1％)、鳞癌9例(8.0％)、小细胞癌4例(3.4％)、不明部位的转移癌5例(4.4％)、间皮瘤5例(4.4％)，骨骼肌组织和纤维脂肪组织 11例(10.1％)，胸膜活检恶性阳性率33.8％，胸水脱落细胞阳性率为 29.4％，总病理确诊率为86.7％，术后并发症主要是气胸3例(4.4％)，胸膜反应2例(2.9％)，出血l例(1.4％)。结论 在胸膜疾病中超声定位针刺胸膜活检是一种有效的诊断手段，阳性率高，致命并发症极少。? 【关键词】 胸膜疾病;超声引导;胸膜活检 ?? Clinical application of the biopsy of pleura with ultrasonic punctures in the pleura disease. WANG Xuan, XU Feng, ZHAO Hong-min, et al.Departmen to Hyperacoustic, The People’s Hospital of Cangzhou, Cangzhou 061000, China ? 【Abstract】 Objective To observe the positive rate and safety of the biopsy of pleurareceive ultrasonic punctures in the pleura disease. Methods Made a retrospective analysis aboutthe clinical data of 102 cases of patients who be diagnosed the disease of pleura with needle biopsy of pleura since the year 2006 to 2010 in our hospital. Results In 102 cases patients, tuberculous pleurisy was 34 cases (30.8％), chronic inflammation was 18 cases (20.8%),adenocarcinoma in 21 cases (18.1%), squamous cell carcinoma 9 cases (8.0%), small cell carcinoma in 4 cases (3.4%), metastatic carcinoma of unknown parts of5 cases (4.4%),mesothelioma in 5 cases (4.4%), skeletal muscle tissue and fibrous adipose tissue in11 cases (10.1%), m alignant pleural biopsy positive rate of 33.8%, pleural effusion cytology-positive rate was 29.4%. Total pathological diagnosis rate of 86.7%, postoperative complications: pneumothorax in 3 cases (4.4%), pleural reaction in 2 cases (2.9%), bleeding l cases (1.4%). Conclusion Ultrasound localization of pleural needle biopsy is an effective diagnostic tool, the positive rate remains high, rarely fatal complications.? 【Key words】 Disease of pleura; Ultrasonic punctures; Biopsy of pleura ? ? 作者单位：061000沧州市人民医院超声科(王璇 赵红敏 张越),呼吸内科(徐锋 梁希军) 超声引导下穿刺活检术是近年来发展起来的一项介入性诊疗技术，此方法损伤性小，安全性高，穿刺结果准确可靠，已经越来越多的应用