单腔深静脉管气胸抽吸后再行经皮肺穿刺活检的临床应用价值  

Clinical application of percutaneous lung re-biopsy after pneumothorax aspiration with deep vein single lumen tube

作　　者：邹容[1] 狄镇海[1] 谭中宝[1] 王庆庆[1] 张建[1] 毛学群[1] ZOU Rong;DI Zhen-hai;TAN Zhong-bao(Department of Interventional Radiology,Affiliated Hospital of Jiangsu University,Zhenjiang 212001,China)

机构地区：[1]江苏大学附属医院介入放射科,江苏212001

出　　处：《放射学实践》2023年第1期89-92,共4页Radiologic Practice

摘　　要：目的:探讨初次经皮肺穿刺活检过程中因气胸而活检失败,使用单腔深静脉管抽气后再行活检的安全性和可行性。方法:2017年8月至2021年8月452例患者行CT引导下肺穿刺活检,其中12例因出现气胸而活检失败,使用单腔深静脉管置入抽气并再次行肺活检。回顾性分析12例患者的病例资料,记录肺内病灶的大小、距离胸膜的距离、病灶在肺叶的位置、有无肺气肿、有无成功获得组织、有无明确的病理结果、有无肺内出血等并发症。结果:12例肺病灶直径为1.5~3.5 cm, 3例距离胸膜较近,平均距离为1.2 cm, 9例距离胸膜较远,平均距离为5.5 cm;8例病灶位于肺下叶,2例位于右肺中叶,2例位于右肺上叶,4例患者有肺气肿;12例患者再次活检后均成功取到组织并有明确的病理结果。活检完成后CT复查有4例出现少量渗出性改变,其中2例少量咯血,均经保守治疗后好转。1例合并肺气肿患者术后1 h出现大量气胸,行胸腔闭式引流后明显缓解。所有患者均未出现胸腔积液或其他严重并发症。结论:初次经皮肺穿刺活检过程中因气胸而活检失败,使用单腔深静脉管抽气后再次行肺活检安全、有效,值得临床推广应用。Objective:The aim of this study was to investigate the safety and feasibility of re-biopsy after pneumothorax aspiration with deep vein single lumen tube for failed biopsy due to pneumothorax during initial percutaneous lung biopsy.Methods:12 out of 452 cases patients suffered failed CT-guided lung biopsies due to pneumothorax during initial percutaneous lung biopsies and underwent lung biopsies again after pneumothorax aspiration using deep vein single lumen tube from August 2017 to August 2021.The data of 12 patients were retrospectively analyzed including the size of the lesion in the lung, the distance from the pleura, the location of the lesion in the lobe, the presence or absence of emphysema, the presence or absence of successfully obtained tissue, the presence or absence of clear pathological results and complications such as intrapulmonary hemorrhage.Results:The diameter of lung lesions ranged from 1.5cm to 3.5cm in 12 cases.There 3 cases close to the pleura in with an average distance of 1.2cm, and 9 cases were farther to the pleura with an average of 5.5cm.There were 8 cases located in the lower lobes of the lung, 2 cases in the right middle lobe, 2 cases in the right upper lobe.4 patients had emphysema.The tissues were successfully obtained after re-biopsy in all 12 patients with clear pathological results.CT re-examination after biopsy showed a small amount of exudative changes in 4 cases, including a small amount of hemoptysis in 2 cases, all of which were improved after conservative treatment.One patient with emphysema developed massive pneumothorax one hour after biopsy, which was significantly relieved after closed thoracic drainage.None of the patients developed pleural effusion or other serious complications.Conclusions:It is safe and effective of re-biopsy after pneumothorax aspiration using deep vein single lumen tube for failed biopsy due to pneumothorax during initial percutaneous lung biopsy, which is worthy of further clinical promotion.

关 键 词：肺活检 经皮肺穿刺 气胸 抽吸 体层摄影术 X线计算机 

分 类 号：R563[医药卫生—呼吸系统] R814.42[医药卫生—内科学]