对比以不同封堵剂封堵经皮穿刺肺活检针道并发症发生率  

Sealed percutaneous lung biopsy tract with different sealants:Comparison on complication incidence

作　　者：宋宪睿 何俊峰[1] 刘扬[1] 熊睿[1] 石包圣 王军 郑文军 SONG Xianrui;HE Junfeng;LIU Yang;XIONG Rui;SHI Baosheng;WANG Jun;ZHENG Wenjun(Department of Ultrasound Medicine,the First Affiliated Hospital of Baotou Medical College,Baotou 014040,China)

机构地区：[1]包头医学院第一附属医院超声医学科,内蒙古包头014040

出　　处：《中国介入影像与治疗学》2025年第4期243-246,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的观察以不同封堵剂封堵经皮穿刺肺活检针道后的并发症发生率。方法回顾性分析129例接受CT引导下经皮穿刺肺活检的单发肺结节患者,根据封堵针道时所用封堵剂将其分为A组[n=37,采用A封堵剂(1g明胶海绵与10ml50%葡萄糖溶液混合)]、B组[n=47,采用B封堵剂(1g明胶海绵与10ml生理盐水混合)封堵针道]、C组[n=45,采用C封堵剂(1g明胶海绵与矛头蛇血凝酶及10ml生理盐水混合)封堵针道]3组;比较组间气胸、咯血等并发症发生率,以二分类logistic回归分析经皮穿刺肺活检后出现并发症的独立影响因素。结果3组性别、年龄、有吸烟史占比及肺气肿占比差异,以及肺结节直径、穿刺肺实质深度及穿刺次数差异均无统计学意义(P均0.05)。共43例(43/129,33.33%)出现并发症,包括B组27例(27/47,57.45%)、A组11例(11/37,29.73%)及C组5例(5/45,11.11%),并发症发生率在B、A、C组间依序降低(P均<0.05)。相比A封堵剂,采用B封堵剂使并发症风险升高[OR(95%CI)=3.190(1.183,8.598),P=0.022]、C封堵剂使并发症风险降低[OR(95%CI)=0.266(0.079,0.889),P=0.031]。结论经皮穿刺肺活检并以B、A、C3种封堵剂封堵针道后,并发症发生率依次降低。Objective To observe the complication incidences after percutaneous lung biopsy and sealed the tract with different sealants.Methods A total of 129 patients with solitary pulmonary nodule who underwent CT-guided percutaneous lung biopsy were retrospectively included and divided into group A(n=37),B(n=47)and C(n=45).The biopsy tract was sealed with sealant A(1 g gelatin sponge particles mixed with 10 ml 50%glucose solution)in group A,with sealant B(1 g gelatin sponge particles mixed with 10 ml normal saline)in group B,while with sealant C(1 g gelatin sponge particles mixed with the coagulant enzyme from Bothrops atroαvenom and 10 ml normal saline)in group C.The incidence rate of complications such as pneumothorax and hemoptysis were comparatively observed among groups.Binary logistic regression was performed to screen the independent influencing factors associated with complications of percutaneous lung biopsy.Results No significant difference of gender,age,proportion of smoking history nor emphysema,diameter of pulmonary nodules,depth of puncture into lung parenchyma nor times of puncture was found among groups(all P>0.05).Complications occurred in 43 cases(43/129,33.33%),i.e.27 cases in group B(27/47,57.45%),11 cases in group A(11/37,29.73%)and 5 cases in group C(5/45,11.11%),and the complication rates decreased order of group B,A and C(all P<o.05).Compared with sealant A,sealant B was associated with increased risk(OR[95%CI]=3.190[1.183,8.598],P=0.022),whereas sealant C was associated with reduced risk(OR[95%CI]=0.266[0.079,0.889],P=0.031)of complications.Conclusion After percutaneous lung biopsy,the complication incidences decreased sequentially when the needle tract was sealed with saline B,A and C.

关 键 词：单发肺结节 活组织检查 粗针 明胶海绵 吸收性 手术后并发症 

分 类 号：R655.3[医药卫生—外科学] R445.3[医药卫生—临床医学]