探讨凝血酶封堵法在老年人经皮肺穿刺活检术中的应用效果。

选取2014年1月至2016年12月118例在连云港市第二人民医院就诊的118例老年患者，其中采用凝血酶封堵法60例（凝血酶封堵法组），采用常规同轴法58例（常规同轴法组），比较两种方法的诊断阳性率及并发症发生率。

凝血酶封堵法组患者诊断为恶性病变57例，未定性3例，阳性诊断率95.0%；发生气胸4例、咯血1例，并发症发生率8.3%。常规同轴法组患者诊断为恶性病变50例，未定性8例，阳性诊断率86.2%；发生气胸9例、咯血6例，并发症发生率25.8%。两组患者均未发生感染、针道种植转移、空气栓塞等并发症。两组患者阳性诊断率的差异无统计学意义（χ²=0.253，P>0.05），并发症发生率的差异有统计学意义（χ²=5.221，P<0.05）。

采用凝血酶封堵法可以准确、安全地对老年患者肺部病灶进行活检，并可明显降低气胸、咯血的发生率。

To investigate whether our new-developed "thrombin blocking" technique in elderly patients can reduce incidence of pneumothorax and hemoptysis when combined with co-axial technique.

From Jan 2014 to Dec 2016, we studied 118 elderly patients CT-guided percutaneous lung biopsy using co-axial and thrombin blocking techniques. These patients were randomly divided into thrombin blocking group (60 cases) and conventional coaxial group (58 cases), researching positive rate and complication rate.

The positive rate of diagnosis was 95% with 57 malignant lesions cases and 3 undetermined case in thrombin blocking group, and the complication rate was 8.3%, 4 cases (6.7%) happened pneumothorax (all were mild pneumothorax), bleedingduring biopsy happened in 1 case (1.7%). The positive rate of diagnosis was 86.2% with 50 malignant lesions cases and 8 undetermined case in conventional coaxial group, and the complication rate was 25.8%, 9 cases (15.5%)happened pneumothorax (7 were mild and 2 were moderate), bleedingduring biopsy happened in 6 (10.3%) case (5 cases with a small amount of hemoptysis and 1 case with 50ml of hemoptysis). No infection, tumor implantation or aeroembolism happened. There was no significant difference in the positive rate of diagnosis between the two groups (χ²=0.253, P>0.05), and the difference in the incidence of complication rate was statistically significant (χ²=5.221, P<0.05).

CT-guided percutaneous lung biopsy using co-axial and thrombin blocking is an accurate, safe, reliable technique for elder patients. The complications of pneumothorax and hemoptysis in elder patients were significantly reduced.