Wang W D
Dept. Radiotherapy, Xingqiao Hospital, Third Military Medical University, PLA, Chongqing, Sichuan.
Zhonghua Zhong Liu Za Zhi. 1991 Sep;13(5):392-4.
The results of rapid percutaneous trough-needle biopsy of lung lesions in 68 cases (76 punctures) is reported. It was successful in 60 of the 68 cases (89.1%). After localizing the lesion on the simulator, TV screen of X-ray machine, or chest film, the procedure was performed with the X-ray switched off. Pneumothorax was observed in 8 cases (8/76 punctures, 10.5%) by routine chest film taken 1 1/2-2 hours after biopsy. 4 patients were asymptomatic (atelectasis below 20%). Pneumothorax could be induced if the needle was at an acute angle with the surface of the pleura at the time of puncture. The needle should pierce the pleura perpendicularly. Premature removal of the pith with the slot tip half-through the pleura might have been another cause of pneumothorax. As the movement of a coin lesion is wide during respiration, the patient must be trained to hold his breath at the end of inspiration or expiration and remains so during the puncture. The chance of success in puncturing a coin lesion could be increased if the lesion is so immobilized and visualized as it is pin-pointed with the rib out of the way at the time of puncture.
报告了68例（76次穿刺）肺部病变快速经皮槽针活检的结果。68例中有60例成功（89.1%）。在模拟器、X线机电视屏幕或胸片上定位病变后，在关闭X线的情况下进行操作。活检后1.5 - 2小时拍摄的常规胸片显示8例（8/76次穿刺，10.5%）出现气胸。4例患者无症状（肺不张低于20%）。如果穿刺时针与胸膜表面呈锐角，可能会诱发气胸。针应垂直刺入胸膜。当槽尖半穿过胸膜时过早取出髓芯可能是气胸的另一个原因。由于钱币状病变在呼吸时移动范围较大，患者必须接受训练，在吸气末或呼气末屏气，并在穿刺过程中保持屏气状态。如果在穿刺时通过避开肋骨使病变固定并清晰可见，穿刺钱币状病变成功的几率可能会增加。
