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find Keyword "肺穿刺" 12 results
  • Electromagnetic navigational bronchoscopy compared with transthoracic needle biopsy for diagnostic yield and safety in peripheral pulmonary lesions

    Objective To evaluate the diagnostic yield and safety of two biopsy methods, electromagnetic navigational bronchoscopy (ENB) and transthoracic needle biopsy (TTNB), in peripheral pulmonary lesions. To select a low-risk and high-benefit biopsy method based on the clinical characteristics of the lesions and patients. Methods A retrospective analysis was conducted on inpatients who underwent ENB and/or TTNB for peripheral pulmonary lesions in Huadong Hospital Affiliated to Fudan University. Propensity score matching was used to compare the diagnostic yield and safety of the two biopsy methods. Results A total of 126 patients were included in the ENB group, and 104 patients in the TTNB group. After propensity score matching, 83 matched pairs were obtained. The TTNB group exhibited a significantly higher diagnostic yield compared with the ENB group (90.4% vs. 48.2%, P<0.001), but it was also associated with a higher incidence of pneumothorax (1.2% vs. 21.7%, P<0.001). In the ENB group, the diagnostic efficacy was correlated with lesion diameter (P<0.001, OR=0.183, 95%CI 0.071 - 0.470), but there was no statistically significant difference in the diagnostic yield among different lung segments (P>0.05). In the TTNB group, lesion characteristics did not significantly affect the diagnostic yield, but a lesion diameter ≤30 mm (P=0.019, OR=5.359, 95%CI 1.320 - 21.753) and a distance from the pleura ≥20mm (P=0.030, OR=6.399, 95%CI 1.192 - 34.360) increased the risk of pneumothorax. When stratified based on lesion and patient blood characteristics, no significant difference was found in the diagnostic yield between the two groups for characteristics such as left upper lobe (P=0.195), right middle lobe (P=0.333), solid with cavity (P=0.567), or abnormal serum white blood cell count (P=0.077). However, the incidence of pneumothorax in the TTNB group was higher than that in the ENB group. Conclusions The diagnostic yield of ENB is affected by the size of the lesion, while the incidence of pneumothorax in TTNB is influenced by both lesion size and distance from the pleura. In cases with lesions located in the left upper lobe, right middle lobe, solid with cavity, or with abnormal serum white blood cell count, selecting ENB for biopsy is considered preferable to TTNB.

    Release date:2023-12-07 04:39 Export PDF Favorites Scan
  • Navigation technique for peripheral pulmonary nodules biopsy

    Peripheral pulmonary lesions (PPLs) are generally considered as lesions in the peripheral one-third of the lung. A computed tompgraphy (CT) guided transthoracic needle aspiration/biopsy or transbronchial approach using a bronchoscope has been the most generally accepted methods. Navigation technique can effectively improve the diagnosis rate of peripheral pulmonary lesions, reduce the incidence of complications, shorten the time of diagnosis, and make the patients get timely and effective treatment.

    Release date:2019-07-17 04:28 Export PDF Favorites Scan
  • Effect of CT-guided percutaneous lung puncture biopsy and nursing of postoperative complications

    Objective To investigate the effect of CT-guided percutaneous lung puncture biopsy and nursing of postoperative complications. Methods We retrospectively analyzed the clinical data of 522 patients who underwent CT-guided percutaneous lung biopsy between May and August 2014 in the Department of Lung Cancer Center. Effect of the puncture biopsy, postoperative complications and nursing measures were summarized. Results After surgery, 507 cases of diagnosis were confirmed, 10 were not confirmed, and 5 cases of puncture were unsuccessful. There were 203 cases of complications, including 122 cases of pneumothorax (23.4%), 56 of hemoptysis 56 (10.7%), 20 of pleural effusion (3.8%), 4 of pleural reaction (0.8%), and 1 of mediastinal emphysema (0.2%). All the above complications were cured after positive symptomatic treatment and nursing care. There were no such complications as severe hemopneumothorax, severe hemoptysis or needle tract metastasis. Conclusions CT-guided percutaneous lung puncture biopsy is a safe and reliable method, but there are some patients with complications. Observation and postoperative care are particularly important. Timely detection and positive care will achieve satisfactory results.

    Release date:2017-01-18 08:50 Export PDF Favorites Scan
  • Clinical application of multislice computed tomography-guided percutaneous transthoracic needle biopsy and influencing factors of its complications

    Objective To investigate the clinical value and complication factors of percutaneous transthoracic needle biopsy (PTNB) guided by multislice computed tomography (MSCT). Methods From January 2013 to December 2016, 179 patients treated with MSCT-guided lung biopsy in the Affiliated Hospital of North Sichuan Medical College and Dianjiang People’s Hospital were reviewed. Occurrence rate and the influencing factors of complications were analyzed. Meanwhile, biopsy findings and diagnostic accuracy rate were summarized. Results A total of 129 cases of lung cancer were detected under MSCT-guided percutaneous biopsy in 179 patients with a diagnostic accuracy of 93.30%. The correct rate of malignant tumor diagnosis was 92.14%. The main complications were pneumothorax, pulmonary hemorrhage, dyspnea and hemoptysis. Major risk factors of MSCT-guided PTNB complications included lesion size ≤ 2 cm, the shortest distance to the diaphragm ≤ 5 cm, puncture depth > 5 cm, pleural puncture angle > 50°, the puncture times ≥ 2, puncture time ≥ 20 minutes, age of patients > 60 years, and existence of pulmonary disease (P<0.05). Conclusions The clinical application value of MSCT-guided PTNB is high. Skilled puncture technique and appropriate puncture procedure are helpful to reduce complications.

    Release date:2017-08-22 11:25 Export PDF Favorites Scan
  • A method of lung puncture path planning based on multi-level constraint

    Percutaneous pulmonary puncture guided by computed tomography (CT) is one of the most effective tools for obtaining lung tissue and diagnosing lung cancer. Path planning is an important procedure to avoid puncture complications and reduce patient pain and puncture mortality. In this work, a path planning method for lung puncture is proposed based on multi-level constraints. A digital model of the chest is firstly established using patient's CT image. A Fibonacci lattice sampling is secondly conducted on an ideal sphere centered on the tumor lesion in order to obtain a set of candidate paths. Finally, by considering clinical puncture guidelines, an optimal path can be obtained by a proposed multi-level constraint strategy, which is combined with oriented bounding box tree (OBBTree) algorithm and Pareto optimization algorithm. Results of simulation experiments demonstrated the effectiveness of the proposed method, which has good performance for avoiding physical and physiological barriers. Hence, the method could be used as an aid for physicians to select the puncture path.

    Release date:2022-08-22 03:12 Export PDF Favorites Scan
  • Diagnostic Value of C-Arm Cone-Beam CT-Guided Percutaneous Transthoracic Needle Biopsy of Lung Nodules: A Meta-analysis

    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.

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  • 显微镜下多血管炎并双肺多叶段实变一例报告和分析

    目的提高对显微镜下多血管炎(MPA)的影像学和临床表现的认识。 方法对确诊的一例以多叶段肺实变为特征的MPA患者进行回顾性分析。 结果患者以咳嗽、咳痰、咯血伴发热1周, 心悸、气短2 d入院。临床出现镜下血尿, 蛋白尿, 心律失常, 巩膜炎, 耳廓皮肤红肿, 贫血, 体重下降等多系统损害。血沉明显增快(150 mm/1 h), 经多种抗菌素、抗病毒药物等治疗无效。在CT定位下经皮肺穿刺活检提示韦格纳肉芽肿, 核周型抗中性粒细胞胞质抗体阳性, 诊断为MPA。给予强的松联合环磷酰胺治疗, 临床症状明显缓解, 实验室指标好转。 结论临床中对双肺多叶段实变, 伴无法解释的临床多系统损害, 经抗炎、抗病毒等治疗无效时, 要考虑到MPA, 应及时行经肺活检及抗中性粒细胞胞质抗体检查以早期诊断, 给予糖皮质激素联合环磷酰胺治疗, 疗效佳。

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  • 经皮肺穿刺活体组织检查术并发胸腔内大出血致休克的护理观察一例

    Release date:2017-06-22 02:01 Export PDF Favorites Scan
  • 防控CT下经皮肺穿刺术后气胸的集束干预研究

    目的探讨防控CT下经皮肺穿刺术后发生气胸的集束干预策略。 方法选择2013年11月-2014年6月入住呼吸科行防控CT下经皮肺穿刺检查患者136例,随机分为试验组、对照组各68例,对照组实施常规围手术期护理,试验组实施集束干预措施。比较两组穿刺一次性成功率、气胸发生率及护士工作依从性。 结果试验组一次性穿刺成功68例,对照组一次性穿刺成功64例,差异无统计学意义(χ2=2.318,P=0.128);试验组发生气胸6例,对照组发生气胸18例,差异有统计学意义(χ2=7.286,P=0.007)。试验组护理效果优于对照组,试验组护士工作依从性优于对照组。 结论集束化干预可提高呼吸科护士专项护理的依从性,保证护理措施实施到位,有效控制经皮肺穿刺术后气胸发生率。

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  • Complications of CT-Guided Percutaneous Lung Biopsy and Its Risk Factors

    Objective To evaluate the complication rate of CT-guided percutaneous lung biopsy and determine the risk factors. Methods A retrospective investigation of patients with CT-guided percutaneous lung biopsy in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine between2002 and 2009 was performed. The risk factors for complications were determined by multivariate analysis of variables related to patients’demographics, lung lesions, biopsy procedures, and individual radiological features. Results 281 biopsy procedures were enrolled. The total complication rate was 55. 9% with pneumothorax 32. 4% ( 91/281) , hemoptysis 34. 5% ( 97 /281) , and cutaneous emphysema2. 1% ( 6 /281) , and with no mortality.The pneumothorax rate was correlated with lesion location, lesion depth, and number of pleural passes. The bleeding risk was correlated with lesion size, lesion depth, and age. Prediction models for pneumothorax and bleeding were deduced by logistic regression. The pneumothorax model had a sensitivity of 80. 0% and a specificity of 62. 4% . And the bleeding model had a sensitivity of 67. 4% and a specificity of 88. 8% .Conclusions Lesion location, lesion depth, and number of pleural passes were independent risk factors for pneumothorax. Lesion size, lesion depth, and age were independent risk factors for bleeding. The prediction models for pneumothorax and bleeding will helpfully reduce the complication of CT-guided lung biopsy.

    Release date:2016-09-13 04:06 Export PDF Favorites Scan
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