摘要
目的探讨在CT导引下行胸部穿刺时,增加成功率减少并发症的方法,分析影响并发症的因素。方法回顾分析188例行CT导引下胸部穿刺的患者,男104例,女84例,年龄12～84岁,平均年龄52.4岁。肺内病变79例,纵隔病变67例,胸膜病变23例,胸壁病变19例。病变包括恶性肿瘤123例,肺内或胸壁脓肿45例,其他病变20例。穿刺目的为穿刺活检诊断111例,穿刺治疗77例。结果CT导引下胸部穿刺188例中,穿刺成功,完成诊疗计划181例,成功率96.28%;穿刺失败,未完成诊疗计划7例,占0.37%。失败7例中,因气胸导致病灶移位,放弃手术4例;因患者不能配合失败1例;插管失败2例。并发症:气胸34例,其中4例需抽气处理,30例自行吸收;咳血25例;术后继发肺感染1例。结论术前充分准备,选择最佳进针点和进针方向,减少穿刺次数,尽量少地经过胸膜层数,缩短手术时间是行CT导引下胸部穿刺术,增加成功率、减少并发症的基本要点。
Objective To probe factors helping to get a higher success rate and a less secondary complications for CT-guided chest centesis. Methods 188 cases of CT-guided chest centesis were reviewed,including 104 men and 84 women ranging 12～84 years old (average age was 52.4) 79 cases were in lungs,67 in mediastinum,23 in pleura,and 19 in chest walls.Lesions were comprised of 123 cases of malignancy,45 of abscess in lungs or chest walls, 20 of others else. The intentions were for biopy (111 cases) or therapy(77). Results 181(96.28%) cases achieved the goals and 7(3.72%) failed.Of the failures, 4 was due to shifting of lesion due to pneumatothorax,1 to patient’ s being unable to offer cooperation and 2 to unsuccessful encheiresis. Secondary complications consisted of 34 pneumatothorax cases (among them 4 underwent air withdrawal,30 experienced spontaneous absorption), 25 hemoptysis cases and 1 case of secondary lung infection. Conclusion The key factors helping to achieve goals include:good pre-operations,best site and direction for pricking,least sessions of pricking,least layers of pleura to be passed and least operation time.
出处
《中国CT和MRI杂志》
2005年第2期31-34,共4页
Chinese Journal of CT and MRI
