The Clinical Value And Safety Analysis Of CT-guided Percutaneous Lung Biopsy And Bronchoscopy Lung Biopsy In The Diagnosis Of Lung Mass

Objective:This study aims to compare the positive rate of puncture,complications and influencing factors of CT-guided percutaneous transthoracic pulmonary biopsies(PTPB)and transbronchoscopic lung biopsy(TBLB)To explore the diagnostic value of the two in the diagnosis of pulmonary space-occupying lesions,analyze the incidence of complications and related influencing factors of the two to prevent,reduce or avoid the occurrence of complications,and guide the clinician to choose the best according to the characteristics of the patient’s lesions Biopsy method.Methods:A retrospective analysis of patients with lung nodules found in our hospital from September 2018 to January 2021,who met the relevant inclusion and exclusion criteria,underwent bronchoscopy-guided lung biopsy and CT-guided lung puncture successively Biopsy,obtained pathological specimens(smear cytology and biopsy histology),a total of 67 cases;divided into bronchoscopy group and CT group,the pathological results obtained by TBLB and PTPB and the incidence of related complications were compared.SPSS22.0 statistical method for analysis,combined with clinical data.Comparing the qualified rate of the two biopsy methods,the positive rate of puncture,the incidence of complications and related influencing factors,the results are concluded.Results:1.A total of 67 patients were enrolled in this study,of which 67 were in the CT group.The qualified rate was 95.52%and the positive rate of puncture was 89.55%.Among them,44 cases were malignant,12 cases were benign,3 cases were suspiciously malignant,and 8 cases were undiagnosed.There were 67 cases in the bronchoscopy group,the qualified rate was 71.64%,and the positive rate of puncture was 52.24%.Among them,23 cases were malignant,9 cases were benign,3 cases were suspected to be malignant,and 32 cases were not clearly diagnosed.The qualified rate and positive rate of puncture in the CT group were higher than those in the bronchoscopy group,and the difference between the two was statistically significant(P<0.05).2.Comparison of the incidence of complications between the two groups:There were no serious complications such as death in the two groups.The main complications were lighter complications such as pneumothorax and pulmonary hemorrhage.The incidence of pneumothorax in the bronchoscopy group was about 1.49%.The incidence was about 7.46%,the incidence of pneumothorax in the CT group was about 10.45%,and the incidence of bleeding was about 22.39%.The incidence of complications in the bronchoscopy group was lower than that in the CT group,and the difference was statistically significant(P<0.05)).3.The positive rate of PTPB puncture is related to 1/3 of the lung field indicated by CT,and has nothing to do with factors such as gender,age,lung lobe location,whether COPD is combined,and whether it has bronchial signs.4.The positive rate of TBLB puncture is related to the lesion diameter ≥2cm,CT suggests that it is located in the 1/3 of the lung field,and the CT signs suggest bronchial signs.It has nothing to do with the patient’s age,gender,lung lobe location,and COPD.5.The incidence of PTPB pneumothorax is related to whether the patient is complicated with chronic obstructive pulmonary disease(COPD),the number of punctures≥ 3 times,and has nothing to do with factors such as age,gender,lesion size,lesion location,and needle insertion depth.The incidence of PTPB pulmonary hemorrhage(perifocal hemorrhage,needle tract hemorrhage)is related to factors such as the diameter of the lesion less than 2cm and the depth of needle insertion≥3 cm,but has nothing to do with factors such as age,gender,location of the lesion,and whether it is combined with COPD.6.The incidence of TBLB complications(pneumothorax,pulmonary hemorrhage)has nothing to do with the patient’s age,gender,lesion size,depth of needle insertion,location of the lesion,and COPD.Conclusion:1.Both are effective methods for diagnosing pulmonary space-occupying lesions,and the positive rate of PTPB puncture is higher.2.When the lung mass is a peripheral lung mass lesion,the positive rate of PTPB puncture is higher,indicating that this technique has high clinical application value and a wide range of clinical applications,especially in the diagnosis of lung cancer in the peripheral lung mass.An effective means of3.When the location of the lesion is close to the hilum and the CT signs suggest bronchial signs,TBLB may be the first choice.4.For patients whose lung biopsy under fiberoptic bronchoscopy cannot clarify the nature of the lesion,CT-guided percutaneous lung biopsy can be considered as an effective supplementary method.5.TBLB has a lower complication rate than PTPB,suggesting that TBLB is safer than PTPB.6.When the lung lesions are small and the puncture path is deep,the probability of complications of PTPB increases.7.When the diameter of lung lesions is ≤2cm and the patient’s cardiopulmonary function is poor,PTPB may be the first choice.