螺旋CT引导下细针经皮肺穿活检术的临床运用.docVIP

螺旋CT引导下细针经皮肺穿活检术的临床运用 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：螺旋CT引导下细针经皮肺穿活检术的临床运用 1 1 材料和方法 2 2 结果 4 3 讨论 4 文2：CT引导下经皮肝穿活检术的临床应用 6 1 资料与方法 6 2 结果 7 3 讨论 7 参考文摘引言： 9 原创性声明（模板） 10 文章致谢（模板） 10 正文 螺旋CT引导下细针经皮肺穿活检术的临床运用 文1：螺旋CT引导下细针经皮肺穿活检术的临床运用 Abstract： Objective To discuss the clinical value of the application of computerized tomography (CT)guided trathoracic fineneedle aspiration biopsy. Methods A total of 125 patients who had undergone CTguided trathoracic fineneedle aspiration biopsy were retrospectively reviewed. All the patients had one or more tumo either in the lungs or on the chest wall. Results Aspiration was all successful. A total of 130 tumo were punctured. Positive diagnoses were made in 102 patients, of whom 22 were diagnosed as squamous cell carcinoma, 45 as adenocarcinoma of lung, 5 as metastatic tumo, 2 as mesothelioma of pleura, 1 as lymphoma, 1 as paragonimiasis, l as hematoma of lung, 3 as pneumoconiosis, 1 as hamartoma, 5 as inflammatory pseudotumor, 3 as tuberculoma, and 13 without pathologic classification (cancer cells were reported). The total rate of positive diagnosis was percent. Among the 125 ones, only 7 suffered pneumothorax due to aspiration. Conclusion The technique of CTguided trathoracic fineneedle aspiration biopsy is a safe and simple method of medical examination with low cost, few complicatio and high positive rate. Key words： lung; trathoracic fineneedle biopsy; spiral computerized tomography 胸部病变复杂多样，特别是肺内孤立性结节，定性诊断比较困难。CT引导下经皮肺穿刺活检术在临床工作中运用日渐广泛[1]，许多肺内或胸膜、胸壁病变能得到及时准确的诊断，并取得病 理学 证据，为以后的 治疗 打下坚实的基础。现在较大的 医院 都采用活检枪进行活检，收费相对较高。我科一直采用细针抽吸式经皮肺穿刺活检术，费用低廉，并发症少，患者均能接受。如果肺内肿块较大，患者不愿意或不适宜手术，在穿刺活检病理证实后，可以进行穿刺消融治疗或植入放射性粒子，取得了较好的临床效果。 1 材料和方法 1．1 一般资料 选取我院2001年3月—2007年10月共做125例130个病灶经皮肺穿刺活检术，术前部分病例行纤支镜检查及查痰均呈阴性。本组男性83例，女性42例，年龄19～78岁，平均年龄54岁。肿块直径范围1．1 cm～12．0 cm，平均为3．8 cm。部分病灶为明确诊断，部分病灶为取得肿瘤的细胞类型为下一步治疗做准备。 1．2 仪器与方法 所有病灶均在东软螺旋CT扫描机上操作，使用6～9号(23～20 G)肺穿活检针。术前常规检查心电图，测定出、凝血时间、血小板计数和凝血酶原时间。 排除严重肺气肿、严重