目的 比较CT引导下经皮肺穿刺(CT-PNB)及气道内径向超声引导下经支气管镜肺活检(EBUS-TBLB)对肺周围型病变(PPL)的诊断价值.方法 回顾性分析2012年12月1日至2014年10月1日在苏州大学附属第一医院诊断为肺周围型病变原因待查的213例患者的临床资料,按照肺活检方式分为CT-PNB组(117例)和EBUS-TBLB组(96例),比较2种活检方法的诊断阳性率、并发症发生率及相关影响因素.结果 CT-PNB组的诊断阳性率(87.2％,102/117)以及并发症发生率(18.8％,22/117)均高于EBUS-TBLB组(61.5％,59/96;4.2％,4/96),差异均有统计学意义(x2 =18.906,P=0.000;x2=10.542,P=0.001).影响因素分析:在CT-PNB组,气胸发生率与病灶大小(x2=5.785,P=0.016)及位置(x2=7.559,P=0.006)相关,病灶贴壁患者中无气胸发生;而在EBUS-TBLB组,活检阳性率与病灶大小(x2=7.995,P=0.004)及位置(x2=4.608,P=0.027)相关.结论 CT-PNB在肺周围型病变诊断中价值高于EBUS-TBLB,虽然气胸及咯血的发生率高于EBUS-TBLB,但并发症多轻微.“,”Objective To evaluate the value of computed tomography-guided percutaneous needle biopsy (CT-PNB) and radial probe endobronchial ultrasound-guided transbronchial lung biopsy (EBUS-TBLB) in the diagnosis of peripheral pulmonary lesions(PPLs).Methods The clinical data of 213 patients who were diagnosed as to have PPLs in the First Mfiliated Hospital of Soochow University between December 1,2012 and October 1,2014 were studied retrospectively.The patients were divided into CT-PNB group and EBUS-TBLB group, according to biopsy methods.The diagnostic yield, complications and influencing factors of both groups were evaluated.Results The diagnostic yield (87.2％, 102/117) and complication rate (18.8％ ,22/117) of the CT-PNB group were higher than those of the EBUS-TBLB group(61.5％ ,59/96 and 18.8％ ,22/117, respectively), the differences being statistically significant (x2 =18.906, P =0.000 and x2 =10.542, P =0.001, respectively).Analysis of the influencing factors showed that there were statistically significant correlations between pneumothorax and the lesion diameter(x2 =5.785, P =0.016)and location(x2 =7.559, P =0.006) in the CT-PNB group.The diagnostic yield was correlated with lesion diameter(x2 =7.995, P=0.004) and location(x2 =4.608, P=0.027) in the EBUS-TBLB group, There was no complicated pneumothorax if the lesions were attached to the chest wall in the CT-PNB group.Conclusions The diagnostic yield of CT-PNB in PPLs was better than that of EBUS-TBLB.Although CT-PNB had a higher complication rates, most complications were mild.