摘要
目的探讨CT引导下肺活检术后速发性气胸和迟发性气胸的危险因素。方法回顾性分析532例接受CT引导下肺活检患者的临床资料。肺活检术后4 h和出院前至少两次复查胸片。根据患者病变和肺活检相关变量评估速发性和迟发性气胸的危险因素。结果共有158例患者发生气胸,其中速发性气胸132例,迟发性气胸26例。病变大小是速发性和迟发性气胸共同的独立危险因素。肺气肿、肺下叶位置、肺内穿刺距离长是速发性气胸的独立危险因素。肺上叶位置和胸膜穿刺次数多是迟发性气胸独立的危险因素。有14例(8.9%)患者需要置胸管或引流管,其中速发性气胸9例,迟发性气胸5例。迟发性气胸组胸管置入率高于速发性气胸组(P<0.01)。结论对于肺气肿、肺下叶病变、肺内穿刺距离长的患者,CT引导下肺活检后往往立即发生气胸。由于迟发性气胸对胸管引流的要求较高,多次穿刺累及肺上叶的小病变需注意监测。
Objective To investigate the risk factors of instant pneumothorax and delayed pneumothorax occurring after CT-guided transthoracic lung biopsy(CTLB).MethodsThe clinical data of 532 consecutive patients who underwent CTLB were retrospectively analyzed.Chest radiography reexamination was employed at least two times at 4 hours after lung biopsy and before discharge.The lesion size and the biopsy-related variables were used to evaluate the risk factors of the instant pneumothorax and delayed pneumothorax.ResultsA total of 158 patients developed pneumothorax,including 132 instant pneumothorax and 26 delayed pneumothorax.The lesion size was an independent risk factor for both the instant pneumothorax and the delayed pneumothorax.Emphysema,lesion located at lower lobe and long puncturing distance were the risk factors for instant pneumothorax,while lesion located at upper lobe and multiple punctures were the risk factors for delayed pneumothorax.Implantation of chest tube or drainage tube had to be carried out in 14 patients(8.9%),including 9 patients with instant pneumothorax and 5patients with delayed pneumothorax.The thoracic tube placement rate in the delayed pneumothorax group was significantly higher than that in the instant pneumothorax group(P<0.01).ConclusionIn patients who have emphysema,lesion located at lower lobe and long puncturing distance,pneumothorax often occurs immediately after CT-guided lung biopsy.In patients who have received multiple punctures and lesion located at upper lobe,delayed pneumothorax is easy to occur,therefor,close attention should be paid to such patients.
作者
刘浩
诸葛雪朋
李世飞
张浩业
王保收
LIU Hao;ZUGE Xuepeng;LI Shifei;ZHANG Haoye;WANG Baoshou(Department of Cardiothoracic Vascular Surgery,Kaifeng Municipal Central Hospital,Kaifeng,Henan Province 475000,China)
出处
《介入放射学杂志》
CSCD
北大核心
2023年第1期69-72,共4页
Journal of Interventional Radiology
关键词
电子计算机断层扫描
肺活检
气胸
computed tomography scan
lung biopsy
pneumothorax
