目的分析比较超声与CT引导下经皮肺穿刺活检在周围型肺部肿块的诊断明确率、并发症发生率并探讨其相关影响因素。方法回顾性分析2013年1月—2015年1月首都医科大学附属北京朝阳医院呼吸内科收治的,经痰脱落细胞、纤维支气管镜检查未能定性,胸部CT显示周围型肺部肿块的成年患者118例。根据其经皮肺活检方法不同分为超声引导组和CT引导组,其中超声引导组57例,CT引导组61例,观察比较二组患者在诊断明确率、并发症发生率的差异并试分析其原因。结果超声引导组穿刺活检诊断明确率93.0%高于CT引导组的88.5%,二组比较差异无统计学意义(χ~2=0.69,P>0.05);二组均未出现血胸、针道转移、呼吸衰竭等严重并发症,超声引导组并发症发生率8.8%低于CT引导组的19.7%,二组比较差异无统计学意义(χ~2=2.84,P>0.05);但超声引导组气胸发生率1.8%低于CT引导组的14.8%,二组比较差异有统计学意义(χ~2=4.86,P<0.05)。结论超声引导经皮肺穿刺活检是一种安全、有效的临床诊断方法,对于周围性肺部肿块,建议首选超声引导穿刺活检。 Objective To analyze and compare the diagnostic accuracy rate and complication rate of percutaneous lung biopsy guided by ultrasound guided by CT and explore the related factors. Methods A retrospective analysis was performed between January 2013 and January 2015 in Beijing Chaoyang Hospital Affiliated to Capital Medical University, Department of Respiratory Medicine, sputum exfoliated cells, fiberoptic bronchoscopy failed to characterize, chest CT showed adult patients with peripheral pulmonary masses example. According to their different methods of percutaneous lung biopsy, they were divided into two groups: ultrasound guided group and CT guided group. Among them, 57 were guided by ultrasound and 61 were guided by CT. The difference of diagnostic accuracy rate and complication rate between the two groups was observed and analyzed The reason. Results The diagnostic accuracy rate of ultrasound-guided biopsy was 93.0% higher than 88.5% of CT-guided group, there was no significant difference between the two groups (χ ~ 2 = 0.69, P> 0.05) (8.8%) in ultrasound-guided group was lower than that in CT-guided group (19.7%). There was no significant difference between the two groups (χ ~ 2 = 2.84, P> 0.05) The incidence of pneumothorax 1.8% was lower than 14.8% of CT guided group, the difference between the two groups was statistically significant (χ ~ 2 = 4.86, P <0.05). Conclusion Ultrasound-guided percutaneous lung biopsy is a safe and effective clinical diagnosis. For peripheral pulmonary masses, it is recommended to use ultrasound-guided biopsy.