CT引导经皮穿刺活检胸部肿瘤并发症危险因素分析  

Analysis of Risk Factors for Complications of Chest Tumor in CT-guided Percutaneous Transthoracic Needle Biopsy

作　　者：陈庆航 傅建斌 郭文震 罗国礼 姚成斌 罗威 CHEN Qinghang;FU Jianbin;GUO Wenzhen;LUO Guoli;YAO Chengbin;LUO Wei(Department of Radiology,Wuzhou Hospital of Traditional Chinese Medicine,Wuzhou,Guangxi Zhuang Autonomous Region,543002 China;Department of Radiology,Wuzhou Integrated Traditional Chinese and Western Medicine Hospital,Wuzhou,Guangxi Zhuang Autonomous Region,543000 China)

机构地区：[1]梧州市中医医院放射科,广西梧州543002 [2]梧州市中西结合医院放射科,广西梧州543000

出　　处：《世界复合医学》2023年第8期39-41,49,共4页World Journal of Complex Medicine

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20190105)。

摘　　要：目的探讨计算机断层扫描(computed tomography,CT)引导下胸部肿瘤经皮经胸穿刺活检(percutaneous transthoracic needle biopsy,PTNB)安全性的影响因素。方法回顾性分析2015年1月—2021年5月梧州市中医医院行CT引导下胸部肿瘤PTNB术,并经病理、临床治疗或随访观察证实的78例患者。根据患者的性别、年龄、病灶直径、穿刺深度、调针次数分析PTNB术后并发症的影响因素。结果60例患者胸部病变取样成功,穿刺病理提示恶性肿瘤47例,良性病变13例。78例CT引导下PTNB并发症发生率为33.33%,气胸发生率为25.64%,肺出血发生率为11.54%,气胸合并肺出血发生率为3.85%,病灶直径≤30 mm发生气胸风险增加(OR=0.205,95%CI:0.049~0.857)、调针次数>3次发生气胸风险增加(OR=4.678,95%CI:1.511~14.482)。结论病灶直径≤30 mm、调针次数>3次会增加气胸发生的风险,CT引导下PTNB是一种对胸部肿瘤创伤小、安全性高。Objective To investigate the factors influencing the safety of computed tomography(CT)guided percutaneous transthoracic needle biopsy(PTNB).Methods A retrospective analysis was performed on seventy-eight patients with chest tumor undergoing CT-guided PTNB surgery in Wuzhou Hospital of Traditional Chinese Medicine from January 2015 to May 2021,and confirmed by pathology,clinical treatment or follow-up observation.The influencing factors of PTNB complications were analyzed according to the patient's gender,age,lesion diameter,puncture depth and needle adjustment times.Results The chest lesions of 60 patients were sampled successfully,and puncture pathology indicated malignant tumors in 47 cases and benign lesions in 13 cases.The incidence of complications of PTNB under CT guidance was 33.33%,pneumothorax 25.64%and pulmonary hemorrhage 11.54%in 78 cases.The incidence of pneumothorax combined with pulmonary hemorrhage was 3.85%,the risk of pneumothorax was increased when the lesion diameter≤30 mm(OR=0.205,95%CI:0.049-0.857),and the risk of pneumothorax was increased when the number of acupuncture adjustment>3 times(OR=4.678,95%CI:1.511-14.482).Conclusion The lesion diameter>30 mm and the number of acupuncture adjustment>3 times will increase the risk of pneumothorax.Ct-guided PTNB is an examination method with less trauma.

关 键 词：胸部 肿瘤 体层摄影术 X线计算机 经皮经胸穿刺活检 

分 类 号：R563[医药卫生—呼吸系统]