Diagnostic Value And Safety Of CT And US-guided PTNB For Peripheral Pulmonary Lesions:A Meta-analysis And Clinical Study

Objective:To evaluate the diagnostic value and safety of CT and sonography-guided PTNB in peripheral pulmonary lesions by Meta-analysis and clinical research.Methods:1.The foreign databases of Pub Med、Embase、The Cochrane Library and Web of Science were searched by computer,and other search approaches were used to collect the randomized controlled trials of CT and ultrasound-guided percutaneous lung biopsy on peripheral pulmonary lesions since the establishment of the database.Extract target data.The quality evaluation refers to the Cochrane quality evaluation standard,and the statistical analysis uses Review Manager5.3 software.2.A retrospective study of the diagnosis rate and complications of patients undergoing CT or ultrasound-guided percutaneous lung biopsy in the First Affiliated Hospital of Dali University from January 2015 to December 2020.Results:1.A total of 1177 patients were included in the Meta-analysis,including 502 patients in the sonography group and 675 patients in the CT group Meta-analysis results showed.that there was no significant difference in the diagnostic rate of ultrasound-guided and CT-guided percutaneous lung biopsy [RR = 1.03,95 % CI(0.99,1.07),P = 0.18].The incidence of complications after percutaneous lung biopsy in the CT group was higher than that in the sonography group, and the difference was not statistically significant [RR = 0.37,95 % CI(0.25,0.53),P < 0.00001].The incidence of pneumothorax after.percutaneous lung biopsy.in the CT group was higher than that in the sonography group,and the difference was statistically significant [RR = 0.34,95 % CI(0.22,0.52),P < 0.00001].There was no.significant difference in the incidence of bleeding after percutaneous lung biopsy between the CT group and the sonography group [RR = 0.50,95 % CI(0.22,1.14),P = 0.10].2.The clinical results showed that the puncture success rates of sonography group and CT group were 100 %;The pathological diagnosis rate of sonography group was 85.48 %,and that of CT group was 91.67 %,the difference was not statistically significant(P = 0.319).Pneumothorax 3 cases,bleeding 0 cases;CT group 5 cases of pneumothorax,bleeding in 3 cases;There was no significant difference in the total complication rate(P = 0.084),pneumothorax rate(P = 0.455)and bleeding rate(P = 0.160)between the two puncture groups.Conclusion:1.Both ultrasound and CT-guided PTNB are safe and effective methods for the diagnosis of peripheral pulmonary mass.2.According to the actual situation of patients and lesions,select the appropriate guidance,not only can improve the pathological diagnosis rate,but also can reduce the incidence of complications.