C-Papers


LWMC
新型三维穿刺定位引导器在经皮肺穿刺活检术中的应用
Title
Application of a Novel Three-dimensional Puncture Positioning Guide Device in Percutaneous Lung Biopsy
Author
杨清杰;胡蒙;郭明
Institution
厦门大学附属成功医院胸心外科
QKMC
中国微创外科杂志
CN
11-4526/R
ISSN
1009-6604
FBNY
2016-11-20
Volume
v.16;No.188
Issue
11
YM
65-68
GJZ
定位;引导;三维;经皮肺穿刺;肺结节
Keywords
Positioning;Guide;Three-dimension;Percutaneous lung biopsy;Pulmonary nodule
LWZY
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。
Abstract
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.
Ref
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Fund_Code
2015年南京军区医学科技创新经费资助(15DX015)
FileName
ZWWK201611017

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