中文论文


论文题名
新型三维穿刺定位引导器在经皮肺穿刺活检术中的应用
英文题名
Application of a Novel Three-dimensional Puncture Positioning Guide Device in Percutaneous Lung Biopsy
作者
杨清杰;胡蒙;郭明
作者单位
厦门大学附属成功医院胸心外科
期刊名称
中国微创外科杂志
CN号
11-4526/R
ISSN
1009-6604
出版日期
2016-11-20
v.16;No.188
11
页码
65-68
中文关键词
定位;引导;三维;经皮肺穿刺;肺结节
英文关键词
Positioning;Guide;Three-dimension;Percutaneous lung biopsy;Pulmonary nodule
中文摘要
目的探讨自主研制的三维穿刺定位引导器在CT定位下经皮肺小结节穿刺活检术中的应用价值。方法采用配对法对比研究,将66例肺小结节分为常规穿刺组和引导器组。引导器组CT平扫确定穿刺点、进针角度、结节距皮肤的深度后,在引导器的引导下将穿刺针穿到肺结节处,之后沿穿刺针穿入外套管针,退出穿刺针,活检针从外套管针进入到达结节表面活检。比较2组一次穿刺达预定位置率、穿刺过程CT扫描次数、穿刺操作时间和并发症发生率。结果常规穿刺组一次穿刺达预定位置率明显低于引导器组[36.4%(12/33)vs.93.9%(31/33),χ~2=24.091,P=0.000],穿刺过程中CT扫描次数明显长于引导器组[(4.0±0.8)次vs.(3.1±0.3)次,t=6.051,P=0.000],穿刺操作时间明显长于引导器组[(36.9±10.6)min vs.(22.8±6.6)min,t=6.487,P=0.000],2组并发症发生率无统计学差异[18.2%(6/33)vs.6.1%(2/33),χ~2=1.280,P=0.258]。结论三维穿刺定位引导器可使经皮肺穿刺活检更加精确,减少创伤,缩短操作时间。
英文摘要
Objective To evaluate the value of a self-developed three-dimensional puncture positioning guide apparatus in CT-guided percutaneous pulmonary nodules biopsy. Methods A comparative study with matching method was made. A total of 66 patients with pulmonary nodules were divided into either conventional puncture group or guide apparatus group. In the guide apparatus group,a CT scanning was conducted to determine the puncture point,needling insertion angle,and depth between nodule and skin.Under the guidance of the apparatus,a puncture needle was penetrated to the pulmonary nodule,along which a trocar was introduced before the withdraw of the puncture needle. A biopsy needle was inserted to the surface of pulmonary nodule via the trocar. The rates of first puncture reaching target position,number of CT scanning,operation time of biopsy puncture process,and complication rates were compared between the two groups. Results The difference was statistically significant between the conventional puncture group and guide apparatus group in rates of first puncture reaching target position [36. 4%( 12 /33) vs. 93. 9%( 31 /33),χ~2= 24. 091,P =0. 000],number of CT scanning [( 4. 0 ± 0. 8) times vs.( 3. 1 ± 0. 3) times,t = 6. 051,P = 0. 000 ],and operation time of biopsy puncture process [( 36. 9 ± 10. 6) min vs.( 22. 8 ± 6. 6) min,t = 6. 487,P = 0. 000]. The complication rates between the two groups were not statistically different [18. 2%( 6 /33) vs. 6. 1%( 2 /33),χ~2= 1. 280,P = 0. 258]. Conclusion Three-dimensional puncture positioning guide device makes percutaneous lung biopsy more precise,less trauma,and less time consuming.
参考文献
1 Birchard KR.Transthoracic needle biopsy.Semin Interv Radiol,2011,28(1):87-97. 2 王玉涛,赵晓东,王海涛,等.低剂量CT引导肺活检对肺炎型肺癌的诊断价值.中国微创外科杂志,2013,13(8):740-742. 3 Tsai IC,Tsai WL,Chen MC,et al.CT-guided core biopsy of lung lesions:a primer.AJR Am J Roentgenol,2009,193(5):1228-1235. 4 Wu CC,Maher MM,Shepard JA.Complications of CT-guided percutaneous needle biopsy of the chest:prevention and management.AJR Am J Roentgenol,2011,196(6):W678-W682. 5 陈兴灿,陆雪华,潘建虎,等.自制定位器CT引导穿刺活检术和介入治疗术.实用放射学杂志,2004,20(3):273-274. 6 Yildirim E,Kirbas I,Harman A,et al.CT-guided cutting needle lung biopsy using modified coaxial technique:factors effecting risk of complications.Eur J Radiol,2009,70(1):57-60. 7 Lee SM,Park CM,Lee KH.C-arm cone-beam CT-guided percutaneous transthoracic needle biopsy of lung nodules:clinical experience in 1108 patients.Radiology,2014,271(1):291-300.
基金
2015年南京军区医学科技创新经费资助(15DX015)

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