摘要
目的探讨挂线法辅助微波针肺结节精准穿刺方法,分析术中影响穿刺结果的若干现象。方法收集107例恶性孤立性肺结节患者临床资料,其中原发性86例,转移性21例。肺结节CT轴状位长径平均(13.6±6)mm。采用挂线法辅助微波针肺结节穿刺。术中无退针,且插入结节中心区域为穿刺成功。记录并分析肺结节穿刺成功率、穿刺并发症和影响穿刺结果的针体裹挟、针体滑脱、针尖推顶、肺结节坠积、结节径向形变、结节掩蔽和针尖径向调针距离等若干现象发生率。结果穿刺成功101例(94.4%),失败6例(5.6%)。气胸23例(21.5%),肺内出血19例(17.8%)。发生针体裹挟9例(8.4%),平均裹挟距离1.2±0.5 cm;针体滑脱6例(5.6%),平均针尖移动距离0.8±0.3 cm;针尖推顶19例(17.8%),平均推顶距离1.6±0.7 cm;肺结节坠积15例(14.0%),平均移动距离0.9±0.5 cm;结节径向形变14例(13.1%),平均牵拉长度增加0.5±0.3 cm;结节掩蔽5例(4.7%);针尖径向平均调针距离0.7±0.4 cm。结论挂线法辅助微波针肺结节穿刺精度较高。术中应注意并处理影响穿刺结果的现象。
Objective To explore a precise method with a microwave antenna for puncture of pulmonary nodules and analyze phenomena that affect the puncture results.Methods Clinical data of 107 cases with solitary malignant pulmonary nodules were collected,and the mean length of pulmonary nodules was 13.6±0.6 mm in CT axial position.A thread-hanging method was used to assist the puncture of pulmonary nodules.The procedure was successful when the needle was not withdrawn and inserted into the central region of the nodule.The success rate and complications of the pulmonary procedure were recorded.The incidence of the following phenomena were also documented:needle coercing,needle slipping,needle tip pushing,pulmonary nodule prolapsing,radial nodule deformation,nodular masking,and radial movement distance of needle tip.Results In all of 107 cases evaluated,the antenna puncture was successful in 101 cases(94.4%)but failed in 6 cases(5.6%).Pneumothorax and pulmonary hemorrhage occurred in 23(21.5%)and 19 cases(17.8%),respectively.The following phenomena occurred:needle coercing in 9 cases(8.4%),needle slipping in 6 cases(5.6%),needle tip pushing in 19 cases(17.8%),pulmonary nodule prolapsing in 15 cases(14%),radial nodule deformation in 14 cases(13.1%),and nodular masking in 5 cases(4.7%).The mean radial adjusting distance of needle tip was 0.7±0.4 cm.Conclusion The thread-hanging method can assist in the accurate puncture of microwave antenna for pulmonary nodules.We should focus and deal with phenomena that may occur and affect the result of puncture.
作者
金辉
谭捷
宋珊
王英虎
马丽华
JIN Hui;TAN Jie;SONG Shan;WANG Yinghu;MA Lihua(Department of Oncology,The 4th Hospital of Hebei Medical University,Shijiazhuang 050011,China;Department of Respiratory,East Campus of Shijiazhuang TCM Hospital,Shijiazhuang 050033,China;Department of Respiratory,The 4th Hospital of Hebei Medical University,Shijiazhuang 050011,China)
出处
《肿瘤防治研究》
CAS
2024年第2期110-114,共5页
Cancer Research on Prevention and Treatment
关键词
CT引导
微波针
精准穿刺
肺结节
CT-guided
Microwave antenna
Accurate puncture
Pulmonary nodules
