目的　探讨纤维支气管镜和CT引导下经皮肺穿刺两种肺活检方法在肺占位性病变中的诊断价值。  方法　严格选择我院及南方医院呼吸科2011年6月至2013年6月期间经胸片或CT诊断为肺部占位性病变患者192例。其中126例行纤维支气管镜检查并行活检取组织，另66例CT引导下经皮肺穿刺活检。观察胸片、CT及纤支镜下肺占位病变大小形态，同时比较两种肺活检方法的确诊阳性率。  结果　采用纤维支气管镜可直接观察到病变部位大小形态；纤支镜肺活检和经皮肺穿刺活检两种方法肺部病变确诊阳性率分别为83.1%和88.7%，两者比较无显著差异（P＞0.05）。纤支镜和经皮肺穿刺并发症发生率分别为1.51%和12.12%，后者显著高于前者，差异具有统计学意义（P＜0.05）。  结论　纤维支气管镜肺活检和CT引导下经皮肺穿刺活检均对肺占位病变有诊断价值，但纤支镜检查相对安全。

Objective　To evaluate the diagnostic value of transbronchial lung biopsy and CT-guide percutaneous lung puncture for occupying leslies in the lung space.　Methods　192 patients with occupying lesions in the lung space were selected and All received chest radiograph and chest CT. 126 of them underwent transbronchial lung biopsy and 66 patients underwent lung biopsy through CT guidedpercutaneous lung punctureThe diagnostic rate of two methods were compared to evaluate the diagnostic value for occupying lesions in the lung space.　Results　The size and shape of occupying lesions in the lung space can be directly observed by bronchofiberscope. The diagnostic rate of occupying lesions in the lung space by transbronchial lung biopsy and CT-guided percutaneous lung puncture were 83.1% and 88.7%. There was no significant difference between two methods for the diagnosis of occupying lesions in the lung space. However, compared to CT-guided percutaneous lung puncture, transbronchial lung biopsy had lower incidence of complication and higher safety with statistical significance (P<0.05).　Conclusion　The diagnostic value of transbronchial lung biopsy and CT-guided percutaneous lung puncture for occupying lesions in the lung space is similar. But compared to CT-guided percutaneous lung puncture, transbronchial lung biopsy is safer.