高原环境下CT引导经皮肺穿刺活检术后并发症的危险因素分析  

Analysis of risk factors for complications after CT-guided percutaneous transthoracic needle biopsy in the plateau environment

作　　者：王恒伟 刘刚[2] 何慧[2] 解晓婷 赵宝魁 姚亮 WANG Hengwei;LIU Gang;HE Hui;XIE Xiaoting;ZHAO Baokui;YAO Liang(Qinghai University Graduate School,Xining 810016,China;Department of Radiology and Intervention,Qinghai Red Cross Hospital,Xining 810000,China)

机构地区：[1]青海大学研究生院,青海西宁810016 [2]青海红十字医院放射影像介入科,青海西宁810000

出　　处：《实用放射学杂志》2024年第5期796-799,共4页Journal of Practical Radiology

基　　金：青海省基础研究计划-应用基础研究项目(2020-ZJ-781)。

摘　　要：目的探讨高原环境下CT引导经皮肺穿刺活检术(PTNB)后并发症的危险因素。方法选取CT引导PTNB的858例患者,回顾性分析患者基本资料、病灶影像学特征、穿刺操作信息、并发症情况及病理结果,总结术后气胸和肺内出血发生的独立危险因素。结果共纳入858例肺活检患者,816例取材成功(95.1%),其中气胸203例(23.7%)、肺内出血140例(16.3%)。气胸统计分析结果表明病灶位置、病灶大小之间差异有统计学意义(P<0.05);肺内出血统计分析结果表明病灶位置、病灶大小、穿刺角度、穿刺深度之间差异有统计学意义(P<0.05);并将引起气胸、肺内出血的独立危险因素绘制森林图。结论高原环境下氧分压及气候温度相对较低,患者心肺功能受到生活环境影响。因此,在保证CT引导PTNB成功率的前提下,选择最优化的路径和时机可降低并发症风险。Objective To investigate the risk factors of complications after CT-guided percutaneous transthoracic needle biopsy(PTNB)in the plateau environment.Methods A total of 858 patients who underwent CT-guided PTNB were selected,and the clinical data of patients,imaging features of lesions,information related to puncture operation,complications,and pathological results were analyzed retrospectively,then the independent risk factors of postoperative pneumothorax and pulmonary hemorrhage were summarized.Results Among 858 patients with lung biopsy,816 cases(95.1%)were successfully sampled,including 203 cases(23.7%)in the pneumothorax and 140 cases(16.3%)in the pulmonary hemorrhage.The statistical analysis results of the pneumothorax revealed significant differences in lesion location and lesion size(P<0.05).The statistical analysis results of the pulmonary hemorrhage showed significant differences in lesion location,lesion size,puncture angle and puncture depth(P<o.05).Independent risk factors affecting pneumothorax and pulmonary hemorrhage were illustrated in a forest plot.Conclusion Because the oxygen partial pressure and climate temperaturc arc relatively low in thc plateau environment,the cardiopulmonary function of patients will be affected by the living environment.Therefore,on the premise of ensuring the success rate of CT-guided PTNB,the optimal path and timing should beselected to reduce the risk of complications.

关 键 词：经皮肺穿刺活检术 气胸 肺内出血 危险因素 

分 类 号：R815[医药卫生—放射医学] R561.4[医药卫生—临床医学] R563.6