How to do lung puncture

Lung biopsy puncture needle is an important part of lung non-vascular interventional technology. For some lesions that are difficult to determine by imaging, cytological histological data obtained through biopsy can make qualitative diagnosis and differential diagnosis, and the choice of treatment options , Formulation and follow-up after treatment, predicting prognosis and other aspects play an important role.

1. First, perform a regular CT scan of the lungs, and then measure the distance and angle from the puncture point to the predetermined puncture target on the CT image. The puncture point is routinely disinfected with skin, draped, and local anesthetized. Measure the puncture depth, make the patient hold his breath, and perform the puncture at a predetermined angle. When puncturing, keep the puncture needle in the same scan level as the puncture point, try to use a direction parallel or perpendicular to the ground. After the puncture is in place, perform a CT partial scan to determine whether the needle tip is in the lesion. If you need to adjust the direction, make the puncture The needle is retracted to the chest wall and adjusted again, or pulled out and punctured again. When adjusting the puncture needle or removing the needle, ask the patient to hold their breath. When the needle is in the body, let the patient breathe calmly and try to avoid coughing. After the puncture is completed, the puncture needle is withdrawn, the puncture specimen is fixed, and the pathological examination is sent.

In recent years, intrapulmonary puncture biopsy has been used more and more widely in the diagnosis and differential diagnosis of clinical diseases. There are many non-vascular guidance methods that can achieve biopsy or treatment purposes. In medical imaging, CT, fluoroscopy, and fluoroscopy are used. Which technique depends on the location, size, and nature of the lesion, as well as the doctor's proficiency, habits, and the patient's proficiency and tolerance. CT-guided percutaneous lung biopsy is relatively simple and has fewer complications.

The biggest advantage of CT-guided puncture is: CT image density resolution is high, and it can clearly show the size, cysticity, presence or absence of necrosis, and the relationship with surrounding tissues and organs. It is not interfered by gas, fat, bone, etc., and the image has no Overlap, thin-layer scanning can be used, the positioning is accurate, and the position of the needle tip can be judged. Therefore, the safety is good, the success rate of biopsy is high, up to 90%, and the treatment effect is also very good. However, CT-guided puncture also has disadvantages: because it is not timely imaging, breathing movement will cause errors in accurate positioning, and the patient must be trained to master the breathing phase. When the puncture needle needs to be at a certain angle with the cross section, the puncture technique has a certain degree of difficulty, and the angle of the gantry can be adjusted.

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