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1、老年患者胸部病变cT引导下穿刺活检的临床分析［摘耍］日的探讨老年人群胸部病变CT引导下穿刺活检的价值和安全性。方法128例行CT穿刺活检的老年胸部病变患者，含肺内病变115例,纵隔病变8例,胸膜病变5例。CT扫描确定并引导穿刺途径，达预定位置取材。回顾总结分析其诊断正确率及并发症发生率。结果128例老年患者的胸部病变屮最终诊断恶性106例，良性22例,CT引导下穿刺活检病理诊断的正确率为91.4%(117/128)o其中良、恶性病变的诊断正确率分别为75・0%(21/28)、90.6%(96/106),恶性病变病理分型的
2、诊断正确率为91.7%(77/84)o23例出现并发症，总发生率为18.0%。包括气胸17例(13.3%),皮下气肿6例，纵隔气肿1例,肺内出血4例,发生率分别为13.3%、4.7%、0.8%、3.1%;无针道种植播散、肺扭转及空气栓塞等并发症发牛。2例气胸患者需行闭式引流，其余患者无须特殊处理。结论CT引导下穿刺活检术，在老年人群的胸部疾病中是一种安全、准确、有效的诊断及鉴别诊断手段。［关键词］胸部病变；活检组织检查；体层摄技术；X线计算机［中图分类号］R446.8［文献标识码］A［文章编号］1673-9701(200
3、9)23-08-04ClinicalAnalysisofCT-guidedBiopsyinElderlyPatientswithChestDiseaseZHENGXilDINGMingchaolCHENGGanglYANGMinghong21.DepartmentofRadiology,BeijingGeriatricsHospital,HaidianDistrict,Beijing100095,China;2.HubuHospital,Shandong262303,China[Abstract]ObjectiveTos
4、tudythevalueandsafetyofCT-guidedpercutaneoustransthoracicbiopsyintheelderlywithchestdiseases.MethodsWeusedCT-guidedbiopsyfor128elder!ypatientswithchestdiseases,ofwhich115casesoflungdisease,8casesofmediastinaldiseaseand5casesofpleuraldiseases.Thewayofguidedpunctur
5、ewasdeterminedbyCTscanandwhentheneedlereachedthedesiredtarget,atissuespecimenwastaken.Thefinaldiagnosisneedtobeconfirmedbysurgery,andpathology.Thediagnosticaccuracyrateandtheincidenceofcomplicationswereanalyzed・Resultslnthe128elderlypatientswithchestdiseases,thef
6、inaldiagnosisshowed106casesofmalignanttumorand22casesofbenign,withthecorrectdiagnosisrateofCT-guidedbiopsyas91.4%(117/128)•Thecorrectdiagnosisratesofbenignandmalignantlesionswere75.0%(21/28),and90.6%(96/106),respectivelyandthediagnosticaccuracyforpathologicaltypi
7、ngofthemalignantlesionswas91.7%(77/84).And23caseshadcomplications.Thetotalincideneewas18.0%,including17casesofpneumothorax(13.3%),6casesofsubcutaneousemphysema,1caseofmediastinalemphysemaand4casesofpulmonaryhemorrhage,withtheincidenceof13.3%,4.7%,0.8%and3.1%,resp
8、ectively.Nocomplicationslikereversepulmonaryandairembolismwerefound・Drainagewasrequiredfor2casesofpneumothorax,andtheremainingpatientsneedednospecialtreatment.
