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[目的]探讨在多层螺旋CT引导的经皮肺穿刺活检术中,应用调节CT扫描机架角度的方法来规避骨性遮挡、优化穿刺路径的价值。[方法]21例常规螺旋CT扫描方式预定的穿刺路径遇到骨性遮挡,改用调节CT扫描机架角度方法引导穿刺。[结果]21例病例经调节CT扫描机架角度方法均获取理想的穿刺路径,成功避开骨性遮挡。一次性穿刺结果的阳性率为95.2%(20/21)。其中18例一次进针穿刺成功,其余均两次进针穿刺成功。术后5例发生并发症,发生率为23.8%(5/21),其中轻度气胸4例,肺内少量出血1例,均经临床观察及对症处理后病情缓解;无严重并发症发生。[结论]在多层螺旋CT引导的经皮肺穿刺活检术中,当常规扫描方式预定的穿刺路径遇到骨性遮挡时,可以采用调节扫描机架角度的方法优化穿刺路径,该方法操作简便、安全可行。
[Objective] To explore the value of adjusting the angle of CT scan to avoid bony occlusion and optimize the puncture path in multi-slice spiral CT-guided percutaneous lung biopsy. [Methods] Twenty-one patients underwent conventional helical CT scan and encountered the occlusion of the bony path, and used the method of adjusting the angle of the CT scan gantry to guide the puncture. [Results] Twenty-one cases got the ideal puncture path by adjusting the angle of the CT scan gantry and successfully avoided the bony occlusion. The positive rate of one-time puncture results was 95.2% (20/21). 18 cases of needle puncture success, the remaining two puncture needle into the success. Postoperative complications occurred in 5 cases, the incidence was 23.8% (5/21), of which mild pneumothorax in 4 cases, a small amount of bleeding in the lung in 1 case, were clinically observed and symptomatic treatment after the remission; no serious complications. [Conclusion] In the multislice CT guided percutaneous pulmonary biopsy, when the conventional puncture path meets the bony occlusion, the method of adjusting the scanning frame angle can be used to optimize the puncture path. The method is simple and easy to operate , Safe and feasible.