周围型肺部新生物超声引导经皮穿刺活检术并发症分析  

Analysis of the complication incidence in performing ultrasound-guided percutaneous biopsy of peripheral pulmonary neoplasm

作　　者：高飞[1] 靳刚[2] 宁洁娟 陈天君[1] Gao Fei;Jin Gang;Ning Jiejuan;Chen Tianjun(Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Xi′an Jiaotong University,Xi′an 710061,China;Department of Medical Imaging,Huashan Central Hospital of Xi′an,Xi′an 710043,China)

机构地区：[1]西安交通大学第一附属医院呼吸与危重症医学科,710061 [2]西安市华山中心医院医学影像科,710043

出　　处：《国际呼吸杂志》2019年第23期1774-1777,共4页International Journal of Respiration

基　　金：陕西省重点研发计划项目(2019KW-037)。

摘　　要：目的分析周围型肺部新生物超声引导下经皮穿刺活检术并发症的发生率及影响因素,以提高穿刺安全性。方法回顾性分析2013年1月至2017年12月因肺脏周围型新生物在西安交通大学第一附属医院住院,经超声引导穿刺活检患者168例,男93例,女75例;年龄(60.8±10.7)岁,年龄范围为29~87岁。统计气胸、咯血、胸膜反应等并发症的发生情况,分析并发症发生与年龄、性别、穿刺次数、穿刺深度、新生物性质、新生物直径、血供状态、有无坏死之间的关系。结果并发症发生率为11.31%(19/168),其中气胸为5.95%(10/168),咯血为4.17%(7/168),胸膜反应为1.19%(2/168)。无肿瘤细胞针道转移、胸腔感染、血胸、栓塞、心脏呼吸骤停等并发症发生。单因素Logistic回归分析发现,不同穿刺次数、穿刺深度、新生物直径均为超声引导经皮穿刺活检术并发症的影响因素(P值均<0.05);但不同性别、年龄、新生物性质、血供状态、坏死与并发症的发生无关(P值均>0.05)。多因素Logistic回归分析发现:新生物直径为并发症发生的保护因子(β=-1.225,OR=0.294)。穿刺次数(β=1.238,OR=3.449)和穿刺深度(β=1.548,OR=4.702)为并发症发生的危险因子。结论周围型肺部新生物超声引导经皮穿刺活检安全有效,并发症发生率低,穿刺次数、穿刺深度及新生物直径是并发症发生的独立影响因素。Objective To explore the influence factors and incidence of complications in ultrasound-guided biopsy of peripheral pulmonary neoplasm,in order to decrease the incidence of complications and improve the safety.Methods The age of 168 cases(male:93,female:75)was 29~87 years old(average age was 60.8±10.7).The data of ultrasound-guided percutaneous lung biopsy in the first hospital affiliated to Xi′an Jiaotong University from January 2013 to December 2017 were retrospectively analyzed.The incidence of complications such as pneumothorax,hemoptysis and pleural reaction was statistically analyzed.To study the relationship of complications with age,gender,puncture times,puncture depth,neoplasm size,blood supply status and presence of necrosis.Results The incidence of complications was 11.31%(19/168),including pneumothorax 5.95%(10/168),hemoptysis 4.17%(7/168),pleural reaction 1.19%(2/168).There was no tumor cell metastasis,chest infection,hemothorax,embolism,cardiac respiratory arrest.In univariate Logistic regression analysis,there were significant differences in the incidence of complications with different puncture times,puncture depth and neoplasm size(all P<0.05).But there were no significant differences in the incidence of complications with different gender,age,nature of neoplasm and blood supply status(all P>0.05).In multivariate Logistic regression analysis,the diameter of the neoplasm was a protective factor for the incidence of complications(β=-1.225,OR=0.294),while puncture times(β=1.238,OR=3.449)and puncture depth(β=1.548,OR=4.702)were risk factors for the incidence of complications.Conclusions The ultrasound-guided biopsy of peripheral pulmonary neoplasm was safe and efficient.The times and depth of thoracic puncture,neoplasm size were the independent factors for the incidence of complications.

关 键 词：超声检查 活组织检查 针吸 手术后并发症 肺部新生物 

分 类 号：R722[医药卫生—儿科]