percutaneous tumor biopsy

Treatment of diseases: preoperative preparation Before the puncture, you should fully understand whether the patient has a history of allergic reactions to local anesthetics and coagulation disorders. It is necessary to comprehensively analyze the patient's recent imaging data to determine the choice of the needle, the path of the needle and the way of guiding, and make the necessary equipment preparation. Before the operation, the patient should be given the necessary explanation to eliminate the nervousness and obtain patient cooperation. Interventional technical equipment: mainly includes two types of puncture needles and guiding equipment. 1. Puncture needles can be roughly divided into three categories: (1) Aspiration needle, the needle has a small diameter, and the tissue damage is small, and only cytological specimens such as Chiba can be obtained. (2) The cutting needle has a relatively large diameter and the needle tip has a different shape. Tissue core or tissue fragments can be obtained during biopsy for pathological diagnosis. Such as Rotex needles, Turner needles, etc. (3) The burr needle has a sharp cutting tooth, and the obtained tissue cells are many, but the tissue damage is large, such as the Franseen needle. 2, the guiding equipment commonly used in guiding equipment is X-ray intensifier - TV system, B-ultrasound, CT and so on. Among them, the use of the X-ray enhancer-television system is most convenient and common. B-ultrasound is affected by the interference of ribs and gas-bearing lung tissue, and the guiding effect is affected. However, B-ultrasound is accurate for cystic or substantial tumors, is not affected by pleural effusion, can distinguish between atelectasis and mass, and has no ionizing radiation. Due to these advantages, B-ultrasound has become one of the commonly used techniques for orientation. CT can clearly show the internal structure of the lesion, determine the biopsy site, and clearly show the pulmonary bullae and leaf crack, to avoid injury when puncture. However, the CT operation is more complicated, and it is not as convenient as the former two, and the cost is high. For these reasons, there are certain restrictions on the use. Surgical procedure 1, biopsy method The choice of biopsy method is determined by the condition and the location of the lesion. (1) A tumor having a wide base portion and close to the chest wall may be a cutting needle or a burr. (2) For a nodular lesion that is away from the chest wall or has liquefaction necrosis, it is better to use aspiration needle. (3) The cutting needle and the trephine are large in damage to the tissue, but the number of acquired tissue cells is large, which is conducive to diagnosis. (4) Aspiration is small for tissue damage, but the number of cells acquired is small, and the diagnostic effect is slightly poor. Therefore, the advantages and disadvantages should be weighed in the selection of the puncture needle, and the factors should be considered in consideration of various factors. 2, operation (1) First make a puncture positioning under the guiding device, select the puncture point and determine the puncture path. (2) Local skin disinfection, drape, and local anesthesia according to surgical routine. (3) When puncture the needle, the patient should hold his breath when breathing calmly. Under the TV surveillance, the puncture needle reaches the pleura through the intercostal muscle. Then let the patient hold their breath while breathing calmly, and quickly puncture the pleura into the lung to reach the lesion. If the guiding device shows that the needle has reached the lesion, and the patient moves, the biopsy needle moves up and down with the lesion, which proves that the needle has penetrated into the lesion and the puncture is successful. (4) Aspirate or cut the pathological tissue according to the selected needle. (5) After taking the pathological tissue, the surgical operation can be ended. When pulling the needle, the patient should also hold his breath and move quickly. The obtained pathological specimens were promptly sent for inspection.

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