CT引导下经皮肺穿刺活检术并发症的影响因素分析  

Complications of CT-guided percutaneous lung puncture biopsy:an analysis of influencing factors

作　　者：杨肖华[1] 黄新宇[1] 汪国祥[1] 

机构地区：[1]皖南医学院弋矶山医院,安徽芜湖241000

出　　处：《介入放射学杂志》2013年第8期658-662,共5页Journal of Interventional Radiology

摘　　要：目的探讨CT定位下经皮肺穿刺活检术并发症发生的影响因素。方法 CT引导下应用意大利PRECISA 18 G切割针对110例患者行经皮肺穿刺活检术,将患者的年龄、性别、病灶大小、切割组织块的多少、穿刺胸膜次数、穿刺时间、病灶深度、病灶周围炎症、慢性肺部病变等相关因素分为不同等级资料,卡方分析不同等级资料之间并发症发生率有无差异性,Logistic回归分析并发症发生的独立危险因素。结果 110例患者术后出现出血28例(占25.5%),气胸27例(占24.5%),卡方分析显示术后出血在病灶大小、病灶深度、穿刺时间及病灶周围炎症之不同组别之间存在差异性(P<0.05);术后气胸在穿刺胸膜次数、穿刺时间、病灶深度、慢性肺部病变之不同组间之间差异有统计学意义(P<0.05)。多因素Logistic回归分析显示病灶大小、病灶深度、病灶周围炎症在出血并发症中具独立危险因素,穿刺时间、穿刺胸膜的次数、慢性肺部病变在气胸并发症中具独立危险因素。结论肺穿刺活检术并发症的发生与病灶大小、穿刺胸膜次数、穿刺时间、病灶深度、病灶周围炎症、慢性肺部病变等相关。Objective To discuss the influencing factors of complications occurring in CT-guided percutaneous pulmonary biopsy.Methods Under CT guidance percutaneous lung puncture biopsy with PRECISA 18 G biopsy needle was carried out in 110 patients.The influencing factors included sex,age,size of lesion,number of cutting tissue block,times of pleural puncturing,operation time,depth of lesion,inflammation around lesion,chronic lung disease,etc.The above data were divided into different grades.The difference in the incidence of complications between the groups with different grades was determined by using χ2 test,while logistic regression analysis was used to evaluate the independent risk factors of the compli cations.Results Of the 110 patients,postoperative bleeding was seen in 28（25.5%） and pneumothorax in 27（24.5%）.Analysis with χ2 test showed that for the occurrence of bleeding the differences in the sizes of lesion,the depth of lesion,puncturing time and inflammation around lesion between the groups with different grades were statistically significant（P 0.05）,while for the occurrence of pneumothorax significant differences in the number of pleural biopsy,puncturing time,the depth of lesion and the presence of chronic lung disease existed between the groups with different grades（P 0.05）.Logistic regression analysis showed that the size of lesion,depth of lesion and inflammation around the lesion were the independent risk factors for postoperative bleeding,while the puncturing time,the number of pleural biopsy and the presence of chronic lung disease were the independent risk factors for pneumothorax.Conclusion The occurrence of complications caused by CT-guided percutaneous transthoracic lung biopsy are related to the size of lesion,the number of pleural biopsy,puncturing time,the depth of lesion,inflammation around lesions and the chronic lung disease.

关 键 词：CT断层扫描 经皮肺穿刺活检术 并发症 

分 类 号：R814.42[医药卫生—影像医学与核医学]