论文部分内容阅读
目的 研究螺旋 CT透视引导下穿刺活检和介入治疗的准确性、安全性及其应用价值。方法 回顾分析我院 2 8例资料完整的病例 ,所有病例均在 CT透视导引下进行。结果 2 8例患者 CT透视导引下穿刺活检及介入治疗均获成功。其中经皮肺穿 1～ 3cm结节灶 2 0例 ,整个穿刺操作约 1 5～ 30分钟 ,启动 CT透视 8～ 2 0秒。 CT透视导引下穿刺成功率 1 0 0 % ,良恶性病变总的诊断准确率 95 % (1 9/ 2 0 ) ,无假阳性 ,无气胸发生 ,其中 1例术后少量痰中带血 ,无大咯血。胸腔局限性脓肿 4例 ,腹腔局限性脓肿 1例 ,均抽出脓液并作细菌培养。其中 1例为冠脉搭桥术后心尖部包裹性脓肿与胸壁切口相通 ,经 CT透视引导下经皮脓肿抽吸及反复冲洗并局部用药后治愈。肝癌 CT透视引导碘油加无水酒精注射治疗 2例 ,周围型肺癌 CT透视引导碘油加化疗药注射治疗 1例 ,CT透视清楚显示所注入高密度碘油的即时存在状态、是否局限于病灶局部或弥散于周围及有否进入血管等。结论 螺旋 CT透视引导下穿刺活检及介入治疗比 X线透视和常规 CT有着明显的优势 ,运用 CT透视技术可以准确、安全、高效地开展微创外科 ,有条件的单位值得推广应用
Objective To study the accuracy, safety and application value of biopsy and interventional therapy guided by spiral CT. Methods Retrospective analysis of 28 cases of complete data in our hospital, all cases under the guidance of CT fluoroscopy. Results 28 cases of patients under the guidance of CT fluoroscopy biopsy and interventional treatment were successful. One percutaneous lung 1 ~ 3cm nodules 20 cases, the entire puncture operation for about 15 ~ 30 minutes, start CT fluoroscopy 8 ~ 20 seconds. CT fluoroscopy guided puncture success rate was 100%, the overall diagnostic accuracy of benign and malignant lesions 95% (1/2 0), no false positive, no pneumothorax, of which a small amount of bloody sputum after surgery, No major hemoptysis. 4 cases of focal thoracic abscess, 1 case of abdominal abscess, both were pus and bacterial culture. One case of coronary artery bypass graft apex wrapped abscess and chest wall incision, guided by CT fluoroscopy percutaneous abscess suction and repeated washing and local medication cured. Liver fluoroscopy guided lipiodol plus anhydrous alcohol injection treatment in 2 cases, peripheral lung cancer CT fluoroscopy guided lipiodol plus chemotherapy drug injection in 1 case, CT fluoroscopy clearly shows that the injection of high-density lipiodol state of existence is limited to the lesion Local or diffuse in the surrounding and have access to blood vessels. Conclusion CT-guided biopsy and interventional biopsy have obvious advantages over X-ray and conventional CT. The minimally invasive surgery can be carried out accurately, safely and efficiently by using CT fluoroscopy, and the qualified units are worthy of popularization and application