数字减影血管造影导向肺穿刺活检对肺周围性病变应用价值.docVIP

数字减影血管造影导向肺穿刺活检对肺周围性病变应用价值【摘要】 目的 评价数字减影血管造影(digital subtraction angiography，DSA)导向经皮肺周围型病变穿刺活检的临床应用价值。方法 在DSA导向下，对57例周围型肺部包块的患者进行穿刺活检，取活检组织标本行细胞学及抗酸染色检查。结果 本组有4例病例因难以配合而终止穿刺，其余53例患者成功取材，穿刺成功率为92.98%(53/57)。51例肺穿刺患者一次作出定性诊断，阳性诊断率为96.23%(51/53)。另2例行二次肺穿术明确诊断。术后并发气胸2例，少量痰中带血1例，并发症发生率为5.67%(3/53)。结论 DSA导向肺穿刺活检定位准确，并发症少，在诊断周围型肺内占位性病变中具有较高的临床应用价值。 【关键词】 活检；数字减影血管造影；细胞学检查；并发症 文章编号：1003-1383(2012)04-0478-03 中图分类号：R 563 文献标识码：A doi:10.3969/j.issn.1003-1383.2012.04.0010 Application of DSA guidance in performing percutaneous fine needle biopsy of surrounding lung lesions LI Yueyong，WEI Zhongheng，LU Jianxun，LUO Biao，ZHANG Zhuobing （Department of Oncology，The Affiliated Hospital of Youjiang Medical University for Nationalites， Baise 533000,Guangxi） 【Abstract】 Objective To evaluate the clinical application of DSA(digital subtraction angiography)guidance in performing percutaneous fine needle biopsy of surrounding lung lesions. Methods Under the guidance of DSA,57 patients with surrounding lung lesions underwent percutaneous fine needle biopsy. Biopsy tissue samples were taken to give cytological and acid-fast stain examination. Results 4 patients could not stand biopsy and gave up.A total of 53 patients successfully underwent biopsy and the success rate was 92.98%(53/57). 51 cases got definite diagnosis and the positive rate was 90.8%(51/53).The other two cases got definite diagnosis in the second biopsy.2 patients suffered pneumothorax and one had bloody sputum,so the complication rate was 5.6%. Conclusion DSA-guided lung biopsy is accurate in localization with fewer complications.It has great value of clinical application in the diagnosis of surrounding pulmonary space occupying lesions. 【Key words】 biopsy；digital subtraction angiography；cytologic diagnosis；complications 肺内占位性病变早期诊断至关重要，定性需行病理活检。肺深部病变，如位于肺门旁，纤支镜检查常可明确［1］；肺周围性病变的明确，常有赖于影像学引导下的肺穿刺活检。目前常用的导向技术有CT及超声，数字减影血管造影(digital subtraction angiography，DSA)导向的肺穿刺活检临床报道及应用相对较少，我科2010年6月～2011