摘要:目的:探讨接受超声引导下经直肠前列腺穿刺活检术(transretal prostatic biopsy,TPB)检查的临床护理相关问题,为前列腺穿刺活检临床护理提供参考。方法:通过心理疏导接解除者术前对TPB的恐惧心理,明确TPB是比较安全、可靠的、不可替代的检查方法,了解手术过程、护理方法和一般并发症,提高TPB的检查效果及护理质量。结果:71例患者进行TPB检查,全部患者均能主动配合检查操作,检查术中并发迷走神经心血管反射1例,术后并发血尿4例,短期内疼痛5例,均早期发现,给与相应的护理与治疗后治愈。结论:TPB是前列腺占位性病变患者有效的定性有创性检查方法,对行TPB检察患者患者应采取针对性的护理措施,提高护理质量及检查安全性。 Abstract: Objective: To investigate correlative nursing measure of patients with transretal prostatic biopsy (TPB) guided by ultrasound, provide reference for clinical nursing of TPB. Methods: We dismissed patient’s fear by psychological nursing, and explained that TPB was a safe, reliable and nosubstitutive checking, and help them understand procedure of operation, nursing measure and common complication, so as to improve effect of checking and quality of care. Results: Seventyone patients received checking with TPB, all patients could initiativiy go with checking, one patient took place pneumogastric nerve reflect, 4 patients take place hematuria postoperation, 5 patients feel soreness in shortterm. All complications were found in morning, and were cure by nursing and treatment. Conclusion: TPB is valid checking method to occupy lesion of prostate for qualitation. Because TPB is a traumatic operation, homologous nursing measure must be take to improve safety of TPB and quality of care.
目的 总结直肠超声引导下经会阴前列腺12点穿刺活检术围手术期的护理经验。 方法 对2010年6月－2012年10月行直肠超声引导下经会阴前列腺12点穿刺活检术932例患者围手术期护理措施及要点予以回顾分析。 结果 932例患者顺利完成穿刺活检，术后除1例患者出现迷走神经反射综合征、经及时抢救缓解外，无其他并发症发生。 结论 直肠超声引导下经会阴前列腺12点穿刺活检术具有安全简便、无需肠道准备、并发症少、准确率高等优点，充分的围手术期护理是该活检术顺利完成的重要因素与环节。
目的 讨论多窗技术+凝血酶封闭在CT导向下经皮肺穿刺活检中的应用价值。 方法 2009年6月－2010年3月收集分析由同一工作组连续完成的CT导向下肺穿刺活检患者共128例，其中A组58例，采用双窗技术+注射生理盐水；B组70例，采用多窗技术+注射凝血酶）。比较两组患者的诊断阳性率、气胸及肺出血发生率的差异。 结果 128例均穿刺成功，A组的穿刺诊断阳性率、气胸发生率及肺出血发生率分别为87.9%、13.8%、17.5%。B组的穿刺诊断阳性率为92.9%，气胸发生率为8.6%，肺出血发生率为5.7%。两组穿刺诊断阳性率和气胸发生率的差异无统计学意义（P＞0.05）；B组肺出血的发生率均明显低于A组，两组间肺内出血的发生率差异有统计学意义（P＜0.05）。 结论 多窗技术+凝血酶针道封闭技术能有助于减少气胸、肺出血等肺穿刺活术的并发症，具有重要的临床应用价值。
目的 采用回顾性研究的方法，分析B型超声引导下的细针穿刺活检能否提高对甲状腺结节诊断的准确性。方法 54例患者行B型超声引导下的细针穿刺活检，另76例患者采用触诊法行细针穿刺活检，并将54例B超引导下的细针穿刺活检结果与手术结果进行比较。结果 超声引导下细针穿刺活检对可触及的甲状腺结节诊断的敏感性为63%，特异性为71%，准确性为65%，阳性预告值为100%，阴性预告值为70%。标本取材不当率为18%； 触诊法细针穿刺活检的灵敏性为47%，特异性为51%，准确性为43%，阳性预告值是54%，取材不当率为28%。B超引导下的细针穿刺活检准确性显著高于触诊法细针穿刺活检。结论 B超引导下的细针穿刺活检能提高手术前甲状腺癌的诊断。
ObjectiveTo systematically review the diagnostic accuracy of C-arm cone-beam CT (CBCT)-guided percutaneous transthoracic needle biopsy (PTNB) for lung nodules. MethodsWe electronically searched databases including PubMed, EMbase, EBSCO, Ovid, CBM, VIP, WanFang Data and CNKI from inception to Feb 28th, 2015, to collect diagnostic studies of CBCT-guided PTNB for lung nodules. Two reviewers independently screened literature, extracted data and assessed the methodological quality of included studies by QUADAS-1 tool. Then, meta-analysis was performed by Stata 12.0 and Meta-DiSc 1.4 softwares for calculating pooled sensitivity (Sen), specificity (Spe), positive likelihood ration (+LR), negative likelihood ration (-LR), and diagnostic odds ratio (DOR), drawing summary receiver operating characteristic (SROC) curve and estimating area under the curve (AUC). ResultsA total of 9 studies involving 1 815 patients were included. The results of meta-analysis showed that the pooled Sen, Spe, +LR,-LR, and DOR were 0.95 (95%CI 0.92 to 0.96), 1.00 (95%CI 0.66 to 1.00), 2 076.58 (95%CI 1.8 to 2.3e+0.6), 0.05 (95%CI 0.04 to 0.08), and 39 443.88 (95%CI 30.53 to 5.1e+0.7), respectively. The AUC of SROC was 0.97 (95%CI 0.95 to 0.98). ConclusionCBCT-guided PTNB can be used as one of the primary examination approaches for lung nodules with relatively high diagnostic accuracy. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
ObjectiveTo explore the diagnostic value of CT-guided percutaneous needle aspiration biopsy (PTNB) for ground-glass opacity (GGO) pulmonary lesions. MethodsA retrospective design was used to collect clinical data of patients with GGO lesions admitted in the Affiliated Hospital of North Sichuan Medical College between Jan. 2009 to Jan 2015. Patients were divided into groups according the lesion size (≤10 mm, 10-20 mm,≥20 mm), length of needle path (≤5 cm, 5-9 cm,≥9 cm) and percentage of GGO component (50%-90%, >90%), respectively. The total and subgroups of sensitivity, specificity, and diagnostic accuracy of CT guided PTNB for diagnosing GGO were calculated and the differences among subgroups were compared using Fisher's exact test. Statistical analysis was conducted by using SPSS 17.0 software. ResultsA total of 60 patients involving 48 malignant and 12 benign lesions were included. The total sensitivity, specificity, and accuracy of CT guided PTNB for diagnosing GGO were 87.5%, 100% and 90%, respectively. There were no significant differences among the subgroups based on the lesion size, length of needle path, and percentage of GGO component (all P values >0.05). ConclusionCT-guided PTNB can be used as one of the diagnostic modalities for lung GGO lesions with a moderate diagnostic value.
ObjectiveTo evaluate the diagnostic value of computer tomography (CT)-guided percutaneous lung biopsy and tissue culture in pulmonary diseases. MethodsAfter the preoperative evaluation, 48 patients underwent CT-guided percutaneous lung biopsy were analyzed, and 16 patients accepted tissue culture. The clinical significance of combined diagnostic rate of histopathology and tissue culture was investigated. ResultsAll patients were punctured successfully. The pathological diagnosis confirmed 26 (54.2%) cases with malignant lesions and 16 (33.3%) cases with benign lesions. Six cases could not be pathological diagnosed. The pathological diagnostic rate was 87.5%. Sixteen patients accepted tissue culture. Among them 3 cases with benign lesions were cultured. The positive rate of tissue culture was 18.8%, and improved to 30.0% in the patients with benign lesion. The combined diagnostic rate of histopathology and tissue culture was 89.6%. In addition, the accuracy rate of pathological diagnosis in the group of lung nodules was 95.0%, higher than the others. The accuracy rate of pathological diagnosis in lung nodules of 2cm~3cm in diameter was 100.0%, and the positive rate of tissue culture in lung lump of 3cm~5cm in diameter was 25.0%. The incidence of pneumothorax and hemorrhage was 14.6%. ConclusionsCT-guided percutaneous lung biopsy is a safe and effective diagnostic method. For pulmonary infectious diseases, combination of CT-guided percutaneous lung biopsy and tissue culture can improve the early diagnostic rate.