CT引导经皮穿刺肺肿瘤微波消融的相关并发症分析  

Analysis of complications of CT-guided percutaneous microwave ablation in patient with lung tumors

作　　者：沈为光 江晓冬 迟庆杰 丁文彬[1] SHEN Weiguang;JIANG Xiaodong;CHI Qingjie;DING Wenbin(Department of Intervention,the Second Affiliated Hospital of Nantong University,Nantong,Jiangsu Province 226001,China)

机构地区：[1]南通大学第二附属医院介入科,江苏南通226001

出　　处：《实用放射学杂志》2023年第10期1682-1685,1689,共5页Journal of Practical Radiology

摘　　要：目的探讨CT引导经皮穿刺肺肿瘤行微波消融(MWA)并发症情况,并对气胸行相关危险因素分析。方法回顾性选取在CT引导下行肺肿瘤MWA治疗的83例患者,共89个病灶,分为气胸组(n=35)和非气胸组(n=54)。统计患者术后并发症的情况,同时对气胸行危险因素分析,包括患者相关因素(年龄、性别、吸烟、肺气肿),肿瘤相关因素(肿瘤大小及性质、位置、距胸膜距离)及治疗相关因素(穿刺体位、经过含气肺组织的长度)。结果主要并发症有:发热、咳嗽、胸痛、气胸、胸腔积液、肺炎、皮下气肿,其中气胸的发生率(39.33%)最高。单因素分析显示,气胸与吸烟(P=0.040)、肺气肿(P=0.034)、肿瘤位置(上叶/中下叶)(P=0.020)及穿刺经过肺组织的长度(P=0.044)存在统计学意义,而气胸与年龄(P=0.096)、性别(P=0.549)、肿瘤大小(P=0.717)、肿瘤性质(P=0.124)及穿刺体位(P=0.068)无明显统计学意义。结论(1)MWA术治疗肺肿瘤安全有效,但亦会产生如发热、咳嗽、胸痛、气胸、胸腔积液、肺炎、皮下气肿等并发症,其中气胸是最常见的并发症。(2)MWA术后气胸的高危因素包括:吸烟史、肺气肿、肿瘤位置及穿刺经过肺组织的长度较长。吸烟、穿刺经过含气肺组织的长度为MWA术后气胸的独立危险因素。Objective To explore the complications of CT-guided percutaneous microwave ablation(MWA)of lung tumors,and to analyze the related risk factors of pneumothorax.Methods A total of 83 patients with 89 lesions who underwent CT-guided MWA for lung tumors were analyzed retrospectively.All lesions were divided into two groups,including pneumothorax group(n=35)and non-pneumothorax group(n=54).The postoperative complications were identified,and the risk factors of pneumothorax were further analyzed,including patient-related factors(age,gender,smoking,emphysema),tumor-related factors(tumor size and property,location,distance from the pleura),and treatment-related factors(puncture position,length of air-containing lung tissue).Results The main complications were fever,cough,chest pain,pneumothorax,pleural effusion,pneumonia,as well as subcutaneous emphysema,and of all complications,the incidence of pneumothorax(39.33%)was the highest.There were significant differences in pneumothorax and smoking(P=0.040),emphysema(P=0.034),tumor location(upper lobe/middle and lower lobe)(P=0.020)and length of puncture through lung tissue(P=0.044)between pneumothorax group and non-pneumothorax group,while there was no statistically significant difference in pneumothorax and age(P=0.096),gender(P=0.549),tumor size(P=0.717),tumor property(P=0.124)and puncture position(P=0.068)between the two groups via univariate analysis.Conclusion(1)MWA is the safe and effective treatment in patient with lung tumors,accompanying with complications such as fever,cough,chest pain,pneumothorax(the highest incidence),pleural effusion,pneumonia,and subcutaneous emphysema.(2)High-risk factors of pneumothorax after ablation including smoking history,emphysema,tumor location,and longer length of puncture through lung tissue.Moreover,smoking and the length of puncture through the air-containing lung tissue are the independent risk factors of pneumothorax after MWA.

关 键 词：肺肿瘤 微波消融 并发症 

分 类 号：R734.2[医药卫生—肿瘤] R815[医药卫生—临床医学]