What are the indications for lung puncture

Lung puncture is a common examination method, that is, entering the lungs through puncturing the visceral layer of the pleural cavity. This is an important method for diagnosing and differentiating diffuse lung lesions and peripheral lesions. Of course, during treatment, it is necessary to understand some indications. If the patient has a long-term cough, lung puncture is not performed unintentionally at this time. This examination method has relatively high requirements and is difficult to operate, so it requires special care, accuracy and speed. For patients, they must actively cooperate to achieve better examination results.

Indications

Lung biopsy is indicated for:

1. Solitary or multiple pulmonary nodules.

2. For lung metastases, the tissue type must be determined in order to find the primary lesion.

3. Pulmonary diseases that cannot be diagnosed by sputum cytology and bronchoscopy.

4. The tissue type must be determined before radiotherapy and chemotherapy for lung malignant tumors in order to develop a treatment plan.

5. Further diagnosis of benign lung lesions.

6. Pulmonary consolidation requires microbiological examination.

Contraindications

Patients with severe bleeding tendency, severe cachexia who cannot tolerate this examination, severe emphysema, cor pulmonale, pulmonary hypertension, heart failure, pulmonary vascular disease, inability to cooperate or severe coughing.

method

1. For lesions of the upper lobe and hilum, puncture is usually performed from the front in the supine position. For lesions of the lingula and middle lobe, puncture is usually performed from the side in the supine position. For lesions of the basal segment and dorsal segment of the lower lobe, puncture is usually performed from the back in the prone position.

2. Select the center of the lesion as the puncture level, and choose the shortest distance (vertical or horizontal distance) from the skin to the lesion as the puncture path, and pay attention to avoid blood vessels, interlobar fissures, and intercostal nerves. When the lesion is located in the posterior segment of the upper lobe apex, an oblique needle insertion is sometimes used to avoid the scapula and ribs.

3. Select the puncture point and path according to the location and size of the lesion shown by CT or fluoroscopy, and mark the puncture point with a marker or gentian violet. The skin at the puncture area is routinely disinfected, covered with a drape, and local anesthesia is performed. Under the guidance of CT or fluoroscopy, the puncture needle is inserted into the lesion, and the patient is asked to hold his breath during needle insertion.

4. After CT or fluoroscopy confirms that the puncture needle tip is in the center of the lesion and there is no necrotic area, pull out the needle core, connect the syringe for negative pressure suction, and pull up the puncture needle to perform multi-point fan-shaped sampling. For solid masses, a cutting needle can be used to obtain specimens.

5. Obtain specimens and send them for pathological examination.