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目的 探讨纵隔病变的不同穿刺途径的临床应用及并发症处理。方法 经X线平片和CT发现的 5 1例纵隔肿块样占位病变 ,在CT引导下采用不同的穿刺途径 ,包括 :①直接 ;②经肺 ;③经胸膜腔途径。用细针抽吸切割方法取样 ,标本块用 10 %甲醛溶液固定 ,病理切片观察。结果 5 1例纵隔病变 ,刺中率 90 .1% (4 6 /5 1) ,正确率88.2 % (4 5 /5 1) ,假阴性率 11.8% (6 /5 1) ,无假阳性发现。穿刺病理结果 ,恶性病变占 72 .5 % ,并发症 ,气胸 4例占 7.8% ,肺内出血现象 3例占 5 .9% ,1例伤及内乳血管。结论 ①CT是目前纵隔病变穿刺活检的最佳手段。②纵隔病变穿刺活检多采用直接和经肺途径。③并发症一般不严重 ,门诊即可处理
Objective To investigate the clinical application and complications of different puncture approaches of mediastinal lesions. Methods Totally 51 cases of mediastinum mass lesions were identified by plain radiography and CT. Different CT punctures were used to guide the CT imaging. They included: ① direct; ② pulmonary; ③ transmucosal approach. With fine needle aspiration sampling method, the specimen block was fixed with 10% formaldehyde solution, pathological observation. Results Fifty-one cases had mediastinal lesions with a rate of 90.1% (46/51), a correct rate of 88.2% (45/51), and a false-negative rate of 11.8% (6/51) . Pathological results of puncture, malignant lesions accounted for 72.5%, complications, 4 cases of pneumothorax accounted for 7.8%, 3 cases of intrapulmonary hemorrhage accounted for 5.9%, 1 case of injury to the milk inside the tube. Conclusion ①CT is the best method for biopsy of mediastinal lesions at present. ② mediastinal lesions biopsy more direct and via the lung route. ③ complications are generally not serious, clinics can handle