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Study of the Complication and Method of Prevention of Lung Biopsy through Skin<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />
周荣林 贾小蕊 闫丹 周卫东 李清娟
河北省保定市第三医院CT室，河北071000
Rong-lin Zhou , Xiao-rui Jia, Dan Yan,Wei-dong Zhou ,Qing-juan Li
Room of CT the Third Hospital of Hebei Province Baoding, 071000 china
Abstract
Objective：Evaluating the occurrence rate of the complicare affect factores and methods of prevention for lung puncture through skin under leaded by CT.
Methods：306 cases which lung nodes or lamps diameter are from 1cm to 11cm,mean diameter 3.5cm were punctured through skin.The path and local were defined by CT scan and measure the depth and the angle of entering needle ,and puncrure rapidly through the cheat wall under local anesthesia to attain anticipate depth ,while getting materials ofter CT scan.the cytology and histology check were made in all of cases.
Results：The rate of complicate was 33.6%(103/306),in these cases, pneamatothorax 9.1%(28/306),the needle way bleed 15.3%(47/306),caugh blood 0.98% (3/306), sputam with blood 4.9%(15/306),3 pneamatothorax cases were treated (2case were treated by drawing gas 1 case were treated by intubation to drain off gas) 3 cases with cough blood in lot were treated by hemostasis,but ligh pnematothorax cases and needle way bleed were not treated.
Conclusion：This is a kind of safe ,accurate and highly sensititive method to qualitative diagnosis because of low rate of complicate.The sensitivity is higher in little lung nodes than in lumps to histology check by puncture through skin.The meathod has very high diagnosis value to early lung cancer.
Key words：Lung tumor, Histology check, Complications, Tomogyaphy, X-ray computed
我院自1999年8月至2003年5月共做胸部CT导引下经皮肺穿刺活检306例，均经手术病理或临床治疗证实。为临床治疗方案的制定提供了科学依据，提高了该项检查的技术和影像诊断水平。关于CT导引下穿刺活检的方法、准确性、阳性率报道较多，但对其并发症的报道甚少。而胸部穿刺并发症是病人和医生共同关注的问题，本文重点探讨其发生的原因和预防的临床价值。现总结分析如下。
一、材料和方法
临床资料 胸部结节、肿块性病变306例，男194例，女112例，年龄10-83岁;39岁以下34例，40-49岁68例，50-59岁63例，60-69岁112例，70岁以上29例，平均年龄56.3岁。306例结节肿块直径1cm～11cm其中＜2cm168例，≥2cm138例，全部病例结合临床和影像诊断高度怀疑肿瘤，行CT导引下穿刺切取标本组织细胞学检查。穿刺针全部选用意大利进口的18、20G套管自动活检针。 | 
