目的：分析CT 引导下经皮肺穿刺与纤维支气管镜在慢性阻塞性肺疾病中的诊断价值。方法： 选取自
2012 年 月至201 年11 月本院住院患者 例( 其中男性 5 例、女性2 例), 釆用CT 引导下经皮肺穿刺、纤维
支气管镜，确诊为慢性阻塞性肺疾病，比较二者灵敏度和特异度, 并进行X2 检验，观察各自疗效。结果：（1） 例
纤维支镜检查患者有1 例出现气胸，1 例检查过程中发生大出血，无其他明显并发症，并发症总发生率为 .1%。
例CT 引导下经皮肺穿刺活检患者中有5 例患者出现并发症，总发生率为1 . %。其中气胸 例，咯血例1，血
胸1 例。比较两组方法，经皮肺穿刺活检并发症显著高于纤维支气管镜检查，差异具有统计学意义。（2）以病理检
查结果定为金标准诊断为大量脓痰阻塞 5 例、痰栓形成及堵塞 例，诊断后总确诊率为 5.55%（确诊例数/ 总
例数100%）。纤维支气管镜诊断灵敏度，特异性，阳性预测值，阴性预测值（NPV）和准确率分别为 0.0%，100%，
100%， . %，和 . %。经皮肺穿刺，其值分别为 0.0%，5 . %， .5%， 5.2%，和 2. %（P=0.052；P<0.001，
P<0.001；P=0.011；P<0.001）。大量脓痰阻塞（ 5 例）诊断准确率，纤维支气管镜准确率高于经皮肺穿刺（ . % 比
. %；P=0.0 ）。痰栓形成及堵塞（ 例）诊断准确率，纤维支气管镜和经皮肺穿刺的同样高（ . % 比 . %；
P=0. ）。结论： 两种检查手段在肺部疾病的诊断上有不同的临床价值, 临床上经有机地结合它们, 能最大程度
地减少漏诊率和误诊率, 并且能获取良好的治疗效果。

Objective To analyze the diagnostic value in patients with chronic obstructive pulmonary disease by CT-guided
percutaneous lung biopsy and bronchoscopy. Methods Since August 2012 to November 2014 in our hospital 69 patients (45
cases were male, female 24 cases), preclude the use of CT-guided percutaneous lung biopsy, bronchoscopy, diagnosed with
chronic obstructive pulmonary lung disease, comparing both the sensitivity and specificity, and X2 test, observe their effect.
Results (1) 33 cases with fiber bronchoscope examination in patients with 1 cases of pneumothorax, bleeding occurred in 1 cases
during inspection, no other complications, the overall complication rate was 6.1%. 36 cases of CT guided percutaneous lung
biopsy in patients with 5 cases of complications, the total occurrence rate is 13.9%. 3 cases of pneumothorax, hemoptysis in 1
cases, 1 cases of hemothorax. Comparison of two groups of methods, percutaneous lung biopsy is significantly higher than that of
fiberoptic bronchoscopy, with significant difference. (2) the pathological findings as the gold standard for the diagnosis for large
amount of purulent sputum obstruction in 35 cases, sputum embolism formation and obstruction in 33 cases, the diagnosis of
total diagnosis rate was 95.55% (the total number of cases of confirmed cases of D / 100%). Fiberoptic bronchoscopy in the diagnosis
of sensitivity, specificity, positive predictive value, and negative predictive value (NPV) and accuracy were 90%, 100%,
100%, 96.7%, and 97.4%. Percutaneous lung puncture, their values were 70%, 59.8%, 37.5%, 85.2%, and 62.4% (P=0.052;
P<0.001, P<0.001; P=0.011; P<0.001). A lot of phlegm obstruction (35 cases) the accuracy rate of diagnosis, fiber bronchoscope
accurate rate is higher than the percutaneous lung biopsy (94.6% vs. 77.8%; P=0.044). The blockage and sputum bolt
form (33 cases) the accuracy rate of diagnosis, fiberoptic bronchoscopy and percutaneous lung puncture the same high (97.9%
vs. 96.3%; P=0.689).Conclusion Both examination methods in the diagnosis of lung disease on different clinical value in
clinical organically combine them, to the greatest extent possible to reduce the rate of misdiagnosis and misdiagnosis rate, and
can get good treatment.