摘要
目的探讨CT导向下经皮肺穿刺活检(TNB)对儿童肺周围性病变的诊断价值及安全性。方法选择广州市妇女儿童医疗中心儿童医院8例肺周围性病变患儿,其中呼吸内科住院患儿7例,胸外科住院患儿1例。所有病例均采用自制标记物行CT扫描标记。在穿刺前对病灶行局部CT扫描,在静脉复合麻醉下,根据病灶部位、大小、穿刺入路及体位等选择穿刺平面、进针点和进针角度并计算合适的进针深度。将CT激光灯按选定层面投照于体表(横断面定位),使用黑色记号笔描记,将自制标记物贴于描记线上再次行CT扫描,选择符合要求的标记点(纵断面定位)作为穿刺点,由介入科医生使用活检针进行穿刺获取病变组织2～3条。固定后送病理学检查。结果术后未见咯血、气胸及肺内出血等并发症发生,无一例因CT导向下TNB死亡。8例患儿病理学检查结果显示,恶性肿瘤3例,良性肿瘤2例,肺结核2例,肺脓疡1例。结论CT导向下TNB对明确儿童肺周围性病变的性质有较大帮助。
Objective To evaluate the clinical value and safety of CT-guided percutaneous transthoracic needle biopsy in pediatric patients with pulmonary peripheral lesions.Methods 7 cases in respiratory department and 1 case in thoracic surgery were selected as research subjects,who were patients with pulmonary peripheral lesions. All of them were scanned by CT before puncture and intravenous combined anesthesia （propofol and ketamine） were implemented. The puncture point,angle and length were selected according to lesion location,size and posture. The body surface was irradiated by laser light of CT according to selected levels （cross-section location）,marked with labels and scanned again. The operator selected the puncture point （vertical section location） up to the requirement,punctured with biopsy needle and obtained lesion tissues （2-3 strips） for pathological examination.Results Among 8 cases,3 were diagnosed malignant sarcomas,2 benign tumors,2 pulmonary tuberculosis and 1 pulmonary Abscess with pleural effusion. Hemoptysis,pneumothorax,or pulmonary hemorrhage was not seen.No complication or death was attributed to percutaneous transthoracic needle biopsy. All cases were diagnosed clearly.Conclusions CT-guided transthoracic needle biopsy has great value for diagnosis of pediatric pulmonary peripheral lesions.
出处
《中国循证儿科杂志》
CSCD
2009年第4期375-379,共5页
Chinese Journal of Evidence Based Pediatrics
关键词
经皮肺穿刺活检
肺周围性病变
儿童
计算机断层扫描
Percutaneous transthoracic needle biopsy
Pulmonary peripheral lesions
Children
Computer tomography
