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目的探讨采用Max-Core活检枪在螺旋CT引导下经皮肺活检诊断肺周边及弥漫性病变的价值。方法在螺旋CT引导下,采用Max-Core活检枪对中国武警医学院附属医院2002-02~2005-01收治的38例肺周围结节性和弥漫性病变进行肺活检。结果检出肺癌30例,其中肺腺癌28例,低分化鳞癌1例,细支气管肺泡癌1例。余8例中,肺结核2例,炎性假瘤2例,特殊表现肺炎2例,肺间质纤维化1例,未获得有意义结果1例。38例肺周边及弥漫性病变经Max-Core活检枪经皮肺活检获阳性结果37例,阳性率为97·36%。手术病人31例,活检枪病理结果与术后病理相符率为100%。副反应轻微,短期内均痊愈。结论螺旋CT引导下采用Max-Core活检枪经皮肺活检是一项简捷、高效、准确和安全的诊断技术,对于肺周围结节性和弥漫性病变的定性具有非常重要的意义。
Objective To investigate the value of percutaneous lung biopsy in diagnosis of peripheral and diffuse lesions with Max-Core biopsy gun guided by spiral CT. Methods Thirty-eight patients with pulmonary nodular and diffuse lesions admitted to the Affiliated Hospital of Chinese Armed Police Forces from February 2002 to January 2005 underwent lung biopsy under the guidance of spiral CT with Max-Core biopsy gun. Results Lung cancer was detected in 30 cases, including 28 cases of lung adenocarcinoma, 1 case of poorly differentiated squamous cell carcinoma and 1 case of bronchioloalveolar carcinoma. In the remaining 8 cases, 2 cases of tuberculosis, 2 cases of inflammatory pseudotumor, 2 cases of special performance pneumonia, pulmonary interstitial fibrosis in 1 case, no meaningful results in 1 case. Thirty-seven cases of peri-pulmonary and diffuse lesions were confirmed by Max-Core biopsy gun percutaneous lung biopsy, the positive rate was 97.36%. Surgical patients in 31 cases, biopsy gun pathological results consistent with postoperative pathology was 100%. Minor side effects, short-term recovery. Conclusion Percutaneous lung biopsy using Max-Core biopsy gun under the guidance of spiral CT is a simple, effective, accurate and safe diagnostic technique, which is of great significance for the qualitative diagnosis of nodular and diffuse lesions around the lung.