CT引导18 G-Bard Magnum活检针在肺穿刺活检中并发症的发生因素

摘要

Objective To analyze the factors related to the occurrence of complications in performing CT-guided percutaneous lung biopsy with 18 G-Bard Magnum needle. Methods CT-guided percutaneous lung biopsy with 18 G-Bard Magnum needle was carried out in a total of 58 patients. The postoperative complications were recorded, and the related factors causing complication were analyzed. Results Successful puncturing was achieved in all patients with a technical success rate of 100%. Postoperative complications included pulmonary hemorrhage (n=11,19.0%), a little amount of bleeding in needle tract (n=7,12.1%), hemoptysis (n=3,5.2%), hemothorax (n=1,1.7%), and pneumothorax (n=10,17.2%). Chi-square test showed that the occurrence of pulmonary hemorrhage bore a close relationship to the lesion’s diameter, the distance between the lesion and the chest wall, the lesion’s location and times of puncturing (P<0.05). The occurrence of pneumothorax was closely correlated with the age, the distance between the lesion and the chest wall, the presence of perifocal emphysema, the lesion’s location and times of puncturing (P<0.05). Univariate analysis indicated that the postoperative complications were liable to occur in the patients whose imaging examination showed perifocal emphysema and lung hilar lesion, and who had more than two independent risk factors (P<0.05). Conclusion CT-guided percutaneous lung biopsy with 18 G-Bard Magnum needle is an accurate and safe technique with relatively higher positive diagnosis rate, but this technique should be carefully used in patients who has perifocal emphysema, or lung hilar lesion, or more than two independent risk factors.(J Intervent Radiol, 2015, 24:792-796)%目的：分析在CT引导下使用18 G-Bard Magnum活检针在经皮肺穿刺活检中并发症发生的相关因素。方法 CT引导下使用18 G-Bard Magnum活检针经皮肺穿刺活检58例，观察术后并发症发生情况，分析其发生的相关因素。结果58例全部穿刺成功，技术成功率100％。术后发生肺出血11例(19.0％)，包括针道少许出血7例(12.1％)，咯血3例(5.2％)，血性胸水1例(1.7％)；气胸10例(17.2％)。χ2检验表明肺出血与病灶的直径、病灶与胸壁间的距离、病灶的位置及穿刺次数显著相关(P＜0.05)；气胸与年龄、病灶与胸壁间的距离、病灶周围气肿、病灶的位置及穿刺次数显著相关(P＜0.05)。单因素比较分析发现：灶周气肿、病灶位于肺门、具有2个以上危险因素术后易发生并发症(P＜0.05)。结论 CT引导下使用18 G-Bard Magnum经皮肺穿刺活检是一种定位准确、安全性相对较高、阳性诊断率高的检查方法，对于灶周气肿、病灶位于肺门、具有2个以上危险因素者应慎重。