论文部分内容阅读
目的评价CT引导下经皮肺穿刺术在高原地区肺结核的诊断价值。方法回顾性分析2016年10月—2017年3月期间接受CT引导下经皮肺穿刺并最终确诊的22例患者的临床资料。结果 22例患者中,男性15例,女性7例,年龄28~71岁,平均年龄(44.7±14.8)岁。合并COPD病史11例(50.0%),高原性心脏病10例(45.5%),2型糖尿病9例(40.9%),高血压病7例(31.8%)。发热7例(31.8%),咳嗽、咳痰12例(54.5%),咯血8例(36.4%),胸痛8例(36.4%),盗汗7例(31.8%),消瘦10例(45.5%),纳差8例(36.4%),无症状(体检发现)9例(40.9%)。22例患者全部穿刺成功,CT引导下经皮肺穿刺活检成功率为100%(22/22),CT穿刺共确诊20例,穿刺物病理阳性率90.90%(20/22),穿刺物抗酸染色阳性率为18.2%(4/22),二者相比差异有统计学意义(χ~2=20.625,P<0.05)。本组共有5例患者出现轻微不良反应。气胸发生率9.1%(2/22),吸氧休息后自行吸收。咯血发生率13.6%(3/22),无大咯血发生。结论 CT引导下经皮肺活检操作简单、安全性高,对高原地区肺结核的诊断具有重要应用价值。
Objective To evaluate the diagnostic value of percutaneous pulmonary puncture guided by CT in the diagnosis of pulmonary tuberculosis in the plateau area. Methods The clinical data of 22 patients undergoing CT-guided percutaneous pulmonary puncture and finally diagnosed from October 2016 to March 2017 were retrospectively analyzed. Results Among the 22 patients, 15 were males and 7 were females, ranging in age from 28 to 71 years with an average age of (44.7 ± 14.8) years. 11 cases (50.0%) had history of COPD, 10 (45.5%) had heart disease, 9 (40.9%) had type 2 diabetes and 7 (31.8%) had hypertension. 7 cases were fever (31.8%), 12 cases (54.5%) were cough and expectoration, 8 cases (36.4%) were hemoptysis, 8 cases (36.4% , Anorexia (36.4%), asymptomatic (physical examination), 9 (40.9%). Twenty-two patients had successful puncture. The success rate of CT guided percutaneous biopsy was 100% (22/22). CT was diagnosed in 20 cases, and the positive rate of puncture was 90.90% (20/22) The positive staining rate was 18.2% (4/22), the difference was statistically significant (χ ~ 2 = 20.625, P <0.05). A total of 5 patients in this group showed mild adverse reactions. The incidence of pneumothorax was 9.1% (2/22). After pneumoperitoneum was resumed, it absorbed itself. The incidence of hemoptysis was 13.6% (3/22), with no major hemoptysis. Conclusion CT-guided percutaneous lung biopsy is simple and safe, and it has important application value in the diagnosis of pulmonary tuberculosis in the plateau area.