Diagnostic value of aspiration plus automatic spring-cut needle biopsy for peripheral lung lesions Guo Yuepeng, Liu Sufen (Department of Respiratory Medicine, First Affiliated Hospital, Xinxiang Medical College, Weihui 453100, China) From October 1999 to September 2001 CT-guided percutaneous lung puncture and automatic spring-cut needle biopsy were performed on 56 patients with peripheral pulmonary lesions that were not diagnosed by routine methods. The results were as follows.
1 Objects and methods 1.1 Objects and methods This group of 56 patients, 31 males and 25 females, aged 29 to 88 years, mean age 48 years. Chest radiographs and CT scans showed peripheral lung masses. The cytology and pathogen examination of sputum and/or pleural effusion were negative, and no abnormal findings were found by fiberoptic bronchoscopy. 40 cases were single lesions and 16 cases were multiple lesions. The minimum lesion was 0.8cmX0.5cm, and the largest lesion was 1.2 puncture instrument. The MANANco*axial cell biopsy needle was produced by MDTECH of the United States, and the MANANtm automatic spring cutting needle manufactured by MDTECH of the United States was used for cutting.
1.3 Preoperative preparation Read chest X-ray and chest CT film in detail, familiar with the location of the lesion. The patient routinely examined platelets, clotting time, prothrombin time, and electrocardiogram. Briefly introduce the patient to the procedure and the necessity of the puncture. Individual emotionally stressed, 5 stable injection 30 minutes before surgery.
1.4 Methods According to the lesion site, supine, prone or lateral, respectively, CT thin-layer scan showed lesions, the shortest distance between the lesion and the chest wall is the puncture point, routine disinfection, local anesthesia, drape. First, use the biopsy to locate the edge of the lesion through the puncture point. The CT scan confirms the correct direction. Then, the needle is inserted into the lesion, the needle core is removed, and the syringe is aspirated by a 50 ml syringe. After the appropriate amount of specimen is taken, the syringe remains negative. Puncture the puncture needle and smear 5 to 8 specimens for pathology and pathogen examination. Then use the cutting needle to penetrate the lesion in the above direction and depth to cut the tissue. If the specimen is small once, the direction can be changed slightly and then cut once. The specimens were strip-shaped and placed in a vial containing formalin solution for pathological examination. CT scan was performed again to observe the complications.å˜± patients recumbent 3h. 2 results 05%, a cutting success rate was 92.95%, the success rate of two cuttings was 100%. The pathological diagnosis rate of aspiration biopsy was 87.5% (49/56), cutting biopsy pathology The diagnosis rate was 96.43%. The pathological and pathological examination results of 256 peripheral lung lesions are shown in Table 1. Table 1 Pathology and pathogenic findings of 56 patients. Pathological and pathogenic examination results. Squamous cell carcinoma adenocarcinoma small cells Lung cancer squamous cell carcinoma inflammatory inflammatory pseudotumor clear cell carcinoma malignant reticuloma cell carcinoma pleural mesothelioma Pneumocystis carinii no abnormality total 2.3 complications 56 cases with a small amount of pneumothorax in 2 cases, a small amount of hemoptysis in 1 case, pleura In one case, the incidence was 7.14% (4/56). 4 cases of complications occurred in 2 cases, and 2 cases of symptomatic treatment recovered within 5 days.
3 Discussion of peripheral pulmonary lesions with tumors and inflammatory lesions more common, the use of conventional methods is difficult to determine the nature of the lesions, fiberoptic bronchoscopy often no abnormal findings. Although a small number of lesions were diagnosed by fiberoptic bronchoscopy, the overall diagnosis rate of peri-pulmonary lesions was still low, about 8.33%~25.21%. The open lung biopsy was traumatic and difficult for patients to accept. X-ray guided lung biopsy is economical, but it is difficult to obtain positive specimens for small lesions because of inaccurate positioning. Lung biopsy is also feasible under the guidance of B-ultrasound, but it shows that the location of the lesion and the needle is often not intuitive enough. In this paper, 56 cases of pulmonary peripheral 1,19%-power O56 patients with sub-aspiration rate were 11 lesions. Initial results were obtained under the guidance of Mil and the automatic bombing (down to page 57). The gene therapy form is being studied in depth for future clinical applications. The combination of stable antisense oligonucleotides and potent chemotherapeutic drugs or immunotoxins may add therapeutic opportunities for central nervous system tumors.
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