| 摘要: |
| 目的 评估CT引导下经皮肺穿刺活组织检查术后气胸发生的影响因素，以期最大程度地减少术后气胸的发生率。方法 回顾性分析2013年1月至2015年4月于第二军医大学长海医院行CT引导下经皮肺穿刺活组织检查术的597例患者的临床和影像学资料。应用Pearson χ2检验、连续性校正χ2检验、Mann-Whitney U检验对CT引导下经皮肺穿刺活组织检查术后发生气胸和未发生气胸患者的基本资料、病灶因素、操作因素等进行比较，用logistic回归模型的参数估计和假设检验对上述资料进行单因素和多因素分析。结果 本组资料中CT引导下经皮肺穿刺活组织检查术后发生气胸者161例，发生率为26.97%。发生气胸与未发生气胸组患者的年龄、病灶长径、病灶位置深度、穿刺体位、经肺、经叶间裂、经间隔旁气泡差异均有统计学意义（Z=1.971、Z=3.823、Z=2.169、χ2=29.196、χ2=11.967、χ2=23.353、χ2=29.970，P<0.05或P<0.01）。多因素分析结果显示，年龄>68岁（OR=1.021，95% CI：1.002~1.040，P=0.032）、经肺（OR=2.251，95% CI：1.110~4.566，P=0.025）、经叶间裂（OR=5.092，95% CI：2.630~9.861，P<0.001）和经间隔旁气泡（OR=6.313，95% CI：2.312~17.243，P<0.001）是CT引导下经皮肺穿刺活组织检查术后气胸发生的危险因素，而病灶长径<3.1 cm（OR=0.826，95% CI：0.732~0.933，P=0.002）和仰卧位（OR=0.318，95% CI：0.209~0.483，P<0.001）是CT引导下经皮肺穿刺活组织检查术后气胸发生的保护因素。结论 患者年龄、病灶长径、穿刺体位（仰卧位）、经肺、经叶间裂、经间隔旁气泡是CT引导下经皮肺穿刺活组织检查术后气胸发生的影响因素。 |
| 关键词: 气胸 经皮针刺肺活检 计算机体层摄影 并发症 危险因素 |
| DOI：10.16781/j.0258-879x.2018.02.0139 |
| 投稿时间：2017-09-19修订日期：2017-11-01 |
| 基金项目: |
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| Analysis of influencing factors of pneumothorax incidence after CT-guided percutaneous core needle biopsy |
| ZHAN Qian△,HUANG Ting△,WANG Tie-gong,PENG Wen-jia,CHEN Lu-guang,SHAO Cheng-wei* |
(Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
△Co-first authors.
* Corresponding author) |
| Abstract: |
| Objective To assess the influencing factors of pneumothorax incidence after CT-guided percutaneous core needle biopsy. Methods The clinical and imaging data of 597 patients, who underwent CT-guided percutaneous core needle biopsy in Changhai Hospital of Second Military Medical University from Jan. 2013 to Apr. 2015, were retrospectively analyzed. Pearson Chi-square test, continuity-adjusted Chi-square test and Mann-Whitney U test were used to compare the general characteristics, nidus factors and operational factors between the post-operative pneumothorax and non-pneumothorax patients. Parameter estimation and hypothesis test of logistic regression model were used for univariate and multivariate analyses of the above-mentioned parameters. Results The incidence of pneumothorax after CT-guided percutaneous core needle biopsy was 26.97% (161/597). There were significant differences between the post-operative pneumothorax and non-pneumothorax groups in the age, nidus length-diameter, nidus depth, body position, traversing aerated lung, traversing interlobar fissure and traversing subpleural bleb (Z=1.971, Z=3.823, Z=2.169, χ2=29.196, χ2=11.967, χ2=23.353, χ2=29.970; P<0.05, P<0.01). Multivariate analysis showed that the age>68 years old (OR=1.021, 95% CI 1.002-1.040, P=0.032), traversing aerated lung (OR=2.251, 95% CI 1.110-4.566, P=0.025), traversing interlobar fissure (OR=5.092, 95% CI 2.630-9.861, P<0.001) and traversing subpleural bleb (OR=6.313, 95% CI 2.312-17.243, P<0.001) were risk factors of the post-operative pneumothorax, and nidus length-diameter<3.1 cm and supine position were the protecting factors (OR=0.826, 95% CI 0.732-0.933, P=0.002; OR=0.318, 95% CI 0.209-0.483, P<0.001). Conclusion The age, nidus length-diameter, body position (supine), traversing aerated lung, traversing interlobar fissure and traversing subpleural bleb are the influencing factors of pneumothorax incidence after CT-guided percutaneous core needle biopsy. |
| Key words: pneumothorax percutaneous needle lung biopsy computed tomography complication risk factor |
