Khesali Aghtaie, Nasrin

Simorgh Research Repository

   داﻧﺸﮕﺎه ﻋﻠﻮم ﭘﺰﺷﻜﻲ ﻛﺮﻣﺎن  داﻧﺸﻜﺪه ﭘﺰﺷﻜﻲ  ﭘﺎﻳﺎن ﻧﺎﻣﻪ دوره ﭘﺰﺷﻜﻲ ﻋﻤﻮﻣﻲ  ﻋﻨﻮان:  ﻫﺎي رﻳﻪ اﻧﺠﺎم ﺷﺪهﺑﺮرﺳﻲ ﻧﺘﺎﻳﺞ و ﻋﻮارض ﺣﺎﺻﻞ از ﺑﻴﻮﭘﺴﻲ  7931ﺗﺎ 5931ﭘﻮر از ﺳﺎل ﺑﺎ ﻫﺪاﻳﺖ ﺳﻲ ﺗﻲ اﺳﻜﻦ در ﺑﻴﻤﺎرﺳﺘﺎن اﻓﻀﻠﻲ         اﺳﺘﺎد راﻫﻨﻤﺎ:  دﻛﺘﺮاﺣﻤﺪ اﻧﺤﺼﺎري    :ﭘﮋوﻫﺶ و ﻧﮕﺎرش  ﻧﺴﺮﻳﻦ ﺧﺼﺎﻟﻲ اﻗﻄﺎﻋﻲ         79ﺑﻬﻤﻦ  ﭼﻜﻴﺪه:( ﺑﻪ TCRHاﺳﻜﻦ ﺑﺎ ﻗﺪرت ﺗﺤﻠﻴﻞ ﺑﺎﻻ)ﺳﻲ ﺗﻲ : ﺑﻴﻮﭘﺴﻲ ﺳﻮزﻧﻲ از ﺿﺎﻳﻌﺎت داﺧﻞ ﻗﻔﺴﻪ ﺳﻴﻨﻪ ﺑﺎ ﻫﺪاﻳﺖ ﻣﻘﺪﻣﻪﺗﺮﻳﻦ آﻧﻬﺎ ﭘﻨﻮﻣﻮﺗﺮاﻛﺲ اﺳﺖ. در ﻳﻚ ﺗﻮاﻧﺪ ﻋﻮارﺿﻲ را ﺑﻪ دﻧﺒﺎل داﺷﺘﻪ ﺑﺎﺷﺪ ﻛﻪ ﺷﺎﻳﻊﺑﺎﺷﺪ وﻟﻲ اﻳﻦ ﻛﺎر ﻣﻲدﻻﻳﻞ ﮔﻮﻧﺎﮔﻮن ارﺟﺢ ﻣﻲش % ﻣﻮارد ﮔﺰار52ﺑﺮرﺳﻲ، ﺑﻴﻮﭘﺴﻲ ﺳﻮزﻧﻲ از ﺿﺎﻳﻌﺎت داﺧﻞ ﻗﻔﺴﻪ ﺳﻴﻨﻪ ﺑﺎﻫﺪاﻳﺖ ﺳﻲ ﺗﻲ اﺳﻜﻦ ارزﻳﺎﺑﻲ ﺷﺪ و ﭘﻨﻮﻣﻮﺗﺮاﻛﺲ در   ﮔﺮدﻳﺪ. آذر ﻛﻪ از ﺑﻴﻤﺎراﻧﻲ ﺗﻤﺎﻣﻲ آزﻣﺎﺋﻲ ﺑﺎﻟﻴﻨﻲ و از ﻧﻮع ﺗﺸﺨﻴﺺ ﺻﻮرت ﮔﺮﻓﺖ.ﺑﻪ ﺷﻜﻞ ﻛﺎر ﻣﻄﺎﻟﻌﻪ ﻫﺎ:ﻣﻮاد و روش وارد ﺷﻮد، ﺑﻴﻮﭘﺴﻲ آﻧﻬﺎ ﺳﻴﻨﻪ ﻗﻔﺴﻪ داﺧﻞ ﺿﺎﻳﻌﺎت ﺑﻮد ﻻزم اﻧﺪ وﻛﺮده ﻣﺮاﺟﻌﻪ ﭘﻮر ﻛﺮﻣﺎناﻓﻀﻠﻲ ﺑﻴﻤﺎرﺳﺘﺎن ﺑﻪ 7931آﺑﺎن ﺗﺎ 5931در ﻣﻄﺎﻟﻌﻪ ﻗﺒﻠﻲ و TCRH ﺷﻴﻮه ﻧﻤﻮﻧﻪ در دﺳﺘﺮس ﺑﻮد. ﺣﺠﻢ ﻧﻤﻮﻧﻪ ﺑﺎ اﺳﺘﺨﺮاج ﺣﺴﺎﺳﻴﺖﮔﻴﺮي ﺑﻪ روش ﻧﻤﻮﻧﻪ .ﺷﺪﻧﺪ ﻣﻄﺎﻟﻌﻪﺳﺎل ﺑﺎ ﻋﻼﻳﻢ ﺑﺎﻟﻴﻨﻲ ﻣﺸﻜﻮك ﺑﻪ  54زن ﺑﺎ ﻣﻴﺎﻧﮕﻴﻦ ﺳﻨﻲ  611ﻣﺮد و  481ﺑﻴﻤﺎر ﺷﺎﻣﻞ  003اﺳﺘﻔﺎده از ﻓﺮﻣﻮل ﻣﺮﺑﻮﻃﻪ ﻣﺸﺨﺺ ﺷﺪ.ﻫﺎي ﭘﺎراﻛﻠﻴﻨﻴﻜﻲ ﻧﻈﻴﺮ دﺳﺖ آﻣﺪه از آزﻣﺎﻳﺶ ﺳﻞ ﺗﻮﺳﻂ دﺳﺘﮕﺎه ﺳﻲ ﺗﻲ اﺳﻜﻦ زﻳﻤﻨﺲ اﺳﻜﻦ ﺷﺪﻧﺪ. و ﻧﺘﻴﺠﻪ اﻳﻦ اﺳﻜﻦ ﺑﺎ ﻧﺘﺎﻳﺞ ﺑﻪاﺳﻤﻴﺮ ﺧﻠﻂ،اﺳﻤﻴﺮ ﺣﺎﺻﻞ از ﻧﻤﻮﻧﻪ، ﺑﺮوﻧﻜﻮآﻟﻮﺗﺮﻻرﻻواژ و ﻛﺸﺖ ﺧﻠﻂ)ﺑﻪ ﻋﻨﻮان اﺳﺘﺎﻧﺪارد ﻃﻼﻳﻲ(ﻣﻘﺎﻳﺴﻪ ﺷﺪ. و ﺳﭙﺲ ﺣﺴﺎﺳﻴﺖ،   ﻫﺎي ﭘﺎراﻛﻠﻴﻨﻴﻜﻲ ﻣﺸﺨﺺ ﮔﺮدﻳﺪ.و ﺿﺮﻳﺐ ﺗﻮاﻓﻖ آن و روش  TCRHوﻳﮋﮔﻲ،ﺻﺤﺖ،ارزش اﺧﺒﺎري ﻣﺜﺒﺖ و ﻣﻨﻔﻲ 42 ﺗﻨﻬﺎ و ﻧﺸﺪ ﻣﺸﺎﻫﺪه ايﻋﺎرﺿﻪ ﮔﻮﻧﻪ ﻫﻴﭻ (38%/4 )ﻧﻔﺮ 052 در ﻣﻄﺎﻟﻌﻪ، ﺗﺤﺖ ﺑﻴﻤﺎر 003 ﻦﺑﻴ از :ﻫﺎﻳﺎﻓﺘﻪﻛﻪ ﻧﺘﻴﺠﻪ اﻳﻦ اﺳﻜﻦ ﺑﺎ ﻧﺘﺎﻳﺞ ﺑﻪ دﺳﺖ آﻣﺪه از  ﮔﺮدﻳﺪ ﻣﺸﺨﺺ آﻣﺪه ﻋﻤﻞ ﺑﻪ ﻣﻄﺎﻟﻌﻪ در .ﺷﺪ ﻋﺎرﺿﻪ رﻳﻮي ﻣﺸﺎﻫﺪه (7%/9)ﺑﻴﻤﺎرﺑﻪ  ،ﺑﺮوﻧﻜﻮآﻟﻮﺗﺮﻻرﻻواژ و ﻛﺸﺖ ﺧﻠﻂ)ﺑﻪ ﻋﻨﻮان اﺳﺘﺎﻧﺪارد ﻃﻼﻳﻲ(ﻫﺎي ﭘﺎراﻛﻠﻴﻨﻴﻜﻲ ﻧﻈﻴﺮ اﺳﻤﻴﺮ ﺧﻠﻂ،اﺳﻤﻴﺮ ﺣﺎﺻﻞ از ﻧﻤﻮﻧﻪ آزﻣﺎﻳﺶ- و ﺿﺮﻳﺐ ﺗﻮاﻓﻖ آن و روش TCRHﺑﻮدو ﺻﺤﺖ،ارزش اﺧﺒﺎري ﻣﺜﺒﺖ و ﻣﻨﻔﻲ 0/19و 0/27، 0/56، 0/7ﺗﺮﺗﻴﺐ داراي ﻫﻤﺒﺴﺘﮕﻲ   (.>p0/50)0/128، 0/285، 0/276/، 127ﻫﺎي ﭘﺎراﻛﻠﻴﻨﻴﻜﻲ ﺑﻪ ﺗﺮﺗﻴﺐ ﻋﺒﺎرﺗﻨﺪ از  ﻫﺪاﻳﺖ ﺑﺎ ﺳﻮزﻧﻲ ﺑﻴﻮﭘﺴﻲ ﺷﻮد ﻛﻪ ازﺑﺮداري از ﺿﺎﻳﻌﺎت ﺗﻮراﻛﺲ ﺗﻮﺻﻴﻪ ﻣﻲﻣﻨﻈﻮر ﻧﻤﻮﻧﻪ ﺑﻪ : ﮔﻴﺮي ﻧﺘﻴﺠﻪ و ﺑﺤﺚ  .ﺷﻮد اﺳﺘﻔﺎده ﻛﻢ ﻋﻮارض وﺟﻮد دﻟﻴﻞ اﺳﻜﻦ ﺑﻪ ﺗﻲ ﺳﻲ ﻛﺮﻣﺎن  اﺳﻜﻦ، ﺗﻲ ﺳﻲ ، ، ﻋﺎرﺿﻪ رﻳﻮي ، ﺳﻞ رﻳﻮي ﺑﻴﻮﭘﺴﻲ : ﻛﻠﻴﺪي ﻛﻠﻤﺎت   :weiveR nacs TC htiw yspoib yranomlup fo snoitacilpmoc dna stluser eht fo yduts ehT 7931 ot 5931 morf latipsoH ruopilazfA ni ecnadiugBackground: Pulmonary tuberculosis disease is one of the problems of our society and the developing countries. The timely diagnosis of pulmonary TB in the prevention of death and illness is of great value. This study was conducted to determine the diagnostic value of CT scan with The high-power analysis (HRCT) in pulmonary tuberculosis is performed. Materials and Methods: The study was performed as a clinical trial and diagnostic. All patients who referred to Afzalipour Hospital in Kerman from December 1395 to November required intra-chest lesions to be biopsied. Sampling method was available in a sample. The sample size was determined by extracting HRCT sensitivity in the previous study and using the relevant formula. 300 patients, including 184 men and 116 women with a mean age of 45 years, with clinical signs of suspected tuberculosis, were scanned by Siemens CT scan. The result of this scan was compared with the results of paraclinical tests such as sputum smear, smear from the specimen, bronchoallectolar filtration and sputum culture (as a gold standard). Then, the sensitivity, specificity, accuracy, positive and negative predictive value of HRCT and coefficient Its agreement and paraclinical methods were determined. Results: Of 300 patients under study, 228 (76%) patients had no complications and only 72 patients (24%) had pulmonary complications. In the study, it was found that the result of this scan with the results obtained from paraclinical experiments such as smear smear, smear from the sample, bronchoallectolar lavage and sputum culture (as a gold standard) had a correlation of 0.7, 0, 72/0 and 0/91 respectively. The accuracy, positive and negative predictive value of HRCT and its agreement coefficient and paraclinical methods were 721/0, 672/0, 582/0, 821/0 (p> 0.05) respectively.  Conclusion: In order to detect pulmonary tuberculosis, it is recommended that a needle biopsy with CT scan leads to low complications. Key words: Biopsy, pulmonary complication, pulmonary tuberculosis, CT scan,Kerma 

بررسي نتايج و عوارض حاصل از بيوپسيهاي ريه انجام شده  با هدايت سي تي اسكن در بيمارستان افضليپور از سال 1395تا 1397

http://eprints.kmu.ac.ir/30904/1/7077.pdf

بررسي نتايج و عوارض حاصل از بيوپسيهاي ريه انجام شده با هدايت سي تي اسكن در بيمارستان افضليپور از سال 1395تا 1397

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