缩短活检相反体位时间对CT引导下肺穿刺活检所致气胸的影响

摘要

目的 评价活检相反体位时间(退出活检针后将病人取相反体位的时间)对CT引导下经皮肺穿刺活检(Percutaneous transthoracic needle biopsy,PTNB)后气胸的影响.方法 回顾性分析360例接受CT引导下PTNB患者的临床资料,将其分为A、B两组.比较A、B两组的气胸发生率、胸腔闭式引流置管率及其危险因素差异.结果 B组患者的平均相反体位时间为7.5±4.3s.A组的气胸发生率(29.52％vs.18.82％)和胸腔闭式引流置管率(10.48％vs.3.92％)均较B组高(P<0.05).A组患者发生气胸的独立危险因素为病变大小和沿针道存在肺气肿(P<0.05),胸腔闭式引流的独立危险因素为沿针道存在肺气肿(P<0.05);B组患者中未见独立危险因素(P>0.05).结论 缩短活检相反体位时间可降低CT引导下PTNB后气胸发生率及胸腔闭式引流置管率.%Objective To evaluate the effect of shortening opposite position biopsy time on the incidence of pneumothorax caused by CT-guided percutaneous transthoracic needle biopsy ( PTNB) . Methods The clinical data of 360 patients received CT-guided PTNB were retrospectively analyzed and divided into two groups. The incidence of pneumothorax and thoracic drainage intubation rate and risk factors were compared. Results The mean opposite po-sition approach time was 7. 5 s ± 4. 3 s in the group B. The incidence of pneumothorax and thoracic drainage intuba-tion rate were higher in the group A than in the group B ( P<0. 05 ) . Lesion size and emphysema along the needle track were independent risk factors for pneumothorax, and the latter was also an independent predictor for insertion of a drainage catheter in the group A (P<0. 05). However, no independent predictor was identified for pneumothorax or insertion of a drainage catheter in the group B ( P>0. 05 ) . Conclusion Rapid opposite position approach can decrease the incidence of pneumothorax and thoracic closed drainage after CT-guided lung biopsy.