CT引导下即刻小负压胸腔引流治疗经皮肺穿刺活检后气胸  

Immediate CT-guided small negative pressure thoracic drainage for pneumothorax after percutaneous lung biopsy

作　　者：焦志梅 韩倩孝 郑永坤 王莉莉[3] 曲红光[3] 马娅琼[3] JIAO Zhimei;HAN Qianxiao;ZHENG Yongkun;WANG Lili;QU Hongguang;MA Yaqiong(The First Clinical College,Gansu University of Chinese Medicine,Lanzhou 730000,China;Department of Medical Imaging,Institute of Medical Imaging,Zhangye People’s Hospital Affiliated to Hexi University,Zhangye 734000,China;Department of Radiology,Gansu Provincial Hospital,Lanzhou 730000,China)

机构地区：[1]甘肃中医药大学第一临床医学院,甘肃兰州730000 [2]河西学院附属张掖人民医院医学影像科医学影像研究所,甘肃张掖734000 [3]甘肃省人民医院放射科,甘肃兰州730000

出　　处：《中国介入影像与治疗学》2025年第3期169-172,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：甘肃省人民医院院内科研基金项目(23GSSYA-1)。

摘　　要：目的观察CT引导下即刻小负压胸腔引流用于治疗经皮肺穿刺活检(PTLB)后气胸的价值。方法回顾性收集172例PTLB后出现单侧气胸患者,对其中83例行CT引导下即刻小负压(约30 mmHg)胸腔引流治疗(A组),对其余89例行床旁胸腔闭式引流治疗(B组);比较组间治疗前临床资料及气胸程度,置管时长及置管时疼痛程度[视觉模拟评分法(VAS)],置管后血氧饱和度、临床症状有无缓解,引流管留置时长、置管后住院时长及是否出现胸膜反应。结果对2组均顺利完成引流。组间临床资料及气胸程度差异均无统计学意义(P均>0.05)。A组置管时长短于、置管时疼痛程度低于B组(P均<0.001),置管后血氧饱和度及症状即刻缓解病例占比均高于B组(P均<0.001),而引流管留置时长及住院时长均短于B组(P均<0.001)。A组2例、B组1例出现胸膜反应,组间胸膜反应差异无统计学意义(P=0.520)。结论CT引导下即刻小负压胸腔引流用于治疗PTLB后气胸有效且安全。Objective To observe the value of immediate CT-guided small negative pressure thoracic drainage for pneumothorax after percutaneous lung biopsy(PTLB).Methods Totally 172 patients of unilateral pneumothorax after PTLB were retrospectively enrolled,including 83 patients underwent immediate CT-guided small negative pressure(about 30 mmHg)thoracic drainage after PTLB(group A)and 89 patients underwent bedside closed thoracic drainage after PTLB(group B).Clinical data before treamtent,degree of pneumothorax,the duration of catheterization,pain degree during catheterization(visual analogue scale[VAS]),blood oxygen saturation after treatment,the ratio of immediate relief of clinical symptoms,duration of drainage retention,duration of hospitalization after treatment and the occurrence of pleural reaction were compared between groups.Results Drainage went smoothly in both groups.No significant difference of clinical data before treatment nor pneumothorax degree was found between groups(all P>0.05).Compared with those in group B,the duration of catheterization was shorter,and pain degree was lower during drainage in group A(both P<0.001).After drainage,blood oxygen saturation and the proportion of immediate relief of clinical symptoms in group A were both higher than those in group B,while the duration of drainage retention and hospitalization were both shorter in group A than those in group B(all P<0.001).Pleural reaction occurred in 2 patients in group A and 1 patient in group B,and no significant difference of pleural reaction was detected between groups(P=0.520).Conclusion Immediate CT-guided small negative pressure thoracic drainage was effective and safe for pneumothorax after PTLB.

关 键 词：肺活检 气胸 引流 

分 类 号：R561.4[医药卫生—呼吸系统] R815[医药卫生—内科学]