分析计算机断层扫描(computed tomography, CT)定位在肺部肿瘤穿刺活检术中的应用。

选择2022年1月至2024年6月我院收治的行CT定位下经皮肺穿刺活检术(CT-guided percutaneous transthoracic needle biopsy, CT-PTNB)152例肺部肿瘤患者为对象，以手术组织病理学结果作为参考标准，分析穿刺成功率、肿瘤诊断并发症及影响因素。

152例手术组织病理学结果呈阳性103例(67.76%)，阴性49例(32.24%)。152例一次性穿刺成功148例(97.37%)，穿刺不成功4例(2.63%)；出现并发症51例，其中单纯气胸27例(52.94%)。CT-PTNB诊断肺部肿瘤的准确度、灵敏度、特异度、阳性及阴性预测值分别为96.71%、97.09%、95.92%、98.04%、94.00%，与手术组织病理学结果一致性良好(Kappa＝0.757，P<0.05)。出现并发症者病灶直径(3.28±1.01)cm低于无并发症者(4.33±1.12)cm，病灶与胸壁距离(4.32±1.07)cm高于无并发症者(3.72±0.97)cm(P<0.05)；Logistic回归分析结果显示，病灶直径增大(OR＝0.542，95%CI：0.419~0.665)是CT-PTNB出现并发症的保护因素，病灶与胸壁距离增大(OR＝3.284，95%CI：1.587~4.981)是CT-PTNB出现并发症的危险因素(P<0.05)。

CT-PTNB在肺部肿瘤诊断中准确度、灵敏度、特异度高，一次性穿刺成功率为97.37%，并发症发生率亦高，主要并发症为单纯气胸，及时优化改进防治措施，有助于提高CT-PTNB成功率及安全性。

To analyze the efficacy of computed tomography(CT) guided percutaneous lung biopsy for pulmonary tumors.

A total of 152 patients with pulmonary tumors who underwent CT-guided percutaneous transthoracic needle biopsy (CT-PTNB) at our hospital from January 2022 to June 2024 were selected as subjects. Using surgical histopathological results as the reference standard, the puncture success rate, diagnostic efficacy, complications, and influencing factors were analyzed.

Among the 152 cases, surgical histopathological results were positive in 103 cases (67.76%) and negative in 49 cases (32.24%). One-time puncture success was achieved in 148 cases (97.37%), while puncture failure occurred in 4 cases (2.63%). Complications occurred in 51 cases, including simple pneumothorax in 27 cases (52.94%). The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of CT-PTNB for diagnosing pulmonary tumors were 96.71%, 97.09%, 95.92%, 98.04%, and 94.00%, respectively, showing good consistency with surgical histopathological results (Kappa=0.757, P<0.05). The lesion diameter in patients with complications was (3.28±1.01) cm, which was smaller than that in patients without complications (4.33±1.12) cm, while the distance from the lesion to the chest wall was (4.32±1.07) cm, which was greater than that in patients without complications (3.72±0.97) cm (P<0.05). Logistic regression analysis showed that an increase in lesion diameter (OR=0.542, 95%CI: 0.419~0.665) was a protective factor against complications in CT-PTNB, while an increase in the distance from the lesion to the chest wall (OR=3.284, 95%CI: 1.587~4.981) was a risk factor for complications in CT-PTNB (P<0.05).

CT-PTNB demonstrates high accuracy, sensitivity, and specificity in the diagnosis of pulmonary tumors, with a one-time puncture success rate of 97.37%. The complication rate is slightly high, with simple pneumothorax being the main complication. Timely optimization and improvement of preventive measures can help enhance the safety of CT-PTNB.