超声引导下经皮肺自动切割针穿刺活检常见并发症危险因素分析  

Analysis of risk factors for common complications in ultrasound-guided percutaneous lung biopsy with automatic cutting needle

作　　者：杨波 周大治[1,2] 汤庆 张雨欣[1,2] 陈武羲 韦东君[1,2] 万登敏 YANG Bo;ZHOU Dazhi;TANG Qing;ZHANG Yuxin;CHEN Wuxi;WEI Dongjun;WAN Dengmin(Department of Ultrasound Medicine,Anshun Municipal People's Hospital,Anshun,Guizhou Province 561000,China)

机构地区：[1]贵州省安顺市人民医院超声医学科,贵州安顺561000 [2]广州医科大学附属第一医院超声医学科

出　　处：《介入放射学杂志》2023年第11期1083-1087,共5页Journal of Interventional Radiology

摘　　要：目的 探究在超声引导下经皮肺自动切割针穿刺活检常见并发症危险因素。方法 回顾分析2022年3月至2022年7月广州医科大学附属第一医院超声引导下经皮肺自动切割针穿刺活检患者共267例,统计常见并发症咯血、气胸及胸膜反应发生情况,分析其与性别、年龄、穿刺次数、病灶大小、空气支气管征、病灶血流、病理类型等因素的相关性,对单因素分析具有统计学意义的因素进行二元logistic回归分析。结果 本次回顾分析267例穿刺病例中常见并发症共32例(12%),其中并发咯血17例(6.4%),均为轻微咯血,予注射止血药物后咯血停止;并发气胸12例(4.5%),11例为少量气胸,1例气胸复查肺压缩35%,气胸均自行吸收,临床未作特殊处理;并发胸膜反应3例(1.1%),均为轻症并自行缓解。χ^(2)检验结果显示:咯血与病灶血流(χ^(2)=9.038,P=0.003)、空气支气管征(χ^(2)=8.044,P=0.005),病理类型(χ^(2)=5.125,P=0.024)相关;气胸与病灶大小(χ^(2)=6.287,P=0.012)相关;胸膜反应与本次研究相关因素无关。多因素二元logistic回归分析提示:空气支气管征(P=0.031,OR=0.306)和病灶血流(P=0.006,OR=0.210)是咯血发生的独立危险因素。结论 超声引导下经皮肺自动切割针穿刺活检作为临床一种重要的有创辅助检查方法,并发症发生率较低,咯血的独立影响因素是空气支气管征和病灶血流,气胸的显著影响因素则是病灶大小。对此,穿刺过程中应谨慎操作,减少并发症的发生。Objective To discuss the risk factors for common complications in ultrasound-guided percutaneous lung biopsy with automatic cutting needle.Methods The clinical data of a total of 267 patients,who received ultrasound-guided percutaneous lung biopsy with automatic cutting needle at the First Affiliated Hospital of Guangzhou Medical University between March 2022 and July 2022,were retrospectively analyzed.The incidences of common complications,including hemoptysis,pneumothorax and pleural reaction,were calculated,and their correlations with the sex,age,number of puncture times,lesion size,air bronchogram sign,lesion's blood flow,pathological type of lesion,etc.were statistically analyzed.The factors that were statistically significant in the univariate analysis were analyzed by binary logistic regression.Results Of the 267patients receiving puncture lung biopsy,common complications occurred in 32(12%).Hemoptysis occurred in17(6.4%) patients,all of which were mild hemoptysis,which was stopped after injection of hemostatic drugs.Pneumothorax occurred in 12 patients(4.5%),among them 11 patients had small amount of pneumothorax,only in one patient the lung compression was up to 35%,and in all patients the pneumothorax was spontaneously absorbed without using any special treatment.Pleural reaction was observed in 3 patients(1.1%),all of which were mild degree and were resolved spontaneously.The χ^(2)test results indicated that the hemoptysis was well correlated with lesion's blood flow(χ^(2)=9.038,P=0.003),air bronchogram sign(χ^(2)=8.044,P=0.005),and pathological type of lesion (χ^(2)=5.125,P=0.024);the pneumothorax was significantly correlated with the lesion size (χ^(2)=6.287,P=0.012);and the pleural reaction bore no relationship to the relevant factors involved in this study.Multivariate binary logistic regression analysis suggested that air bronchogram sign(P=0.031,OR=0.306) and lesion's blood flow(P=0.006,OR=0.210) were the independent risk factors for the occurrence of hemoptysis.Conclusion As a clinical impo

关 键 词：超声引导 肺穿刺 自动切割 并发症 

分 类 号：R563[医药卫生—呼吸系统]