北京生物医学工程2024，Vol.43Issue(6)：634-640,7.DOI:10.3969/j.issn.1002-3208.2024.06.012
CT引导肺穿刺活检技术发生气胸风险及相关技术因素分析
Risk of pneumothorax in CT-guided percutaneous lung biopsy and analysis of related technical factors
摘要
Abstract
Objective To analyze the incidence of pneumothorax during CT-guided percutaneous lung biopsy(PLB)and its related technical factors,providing a scientific basis for reducing the risk of pneumothorax associated with this technique.Methods CT-guided PLB was a highly precise minimally invasive technique,characterized by high accuracy,real-time monitoring,and strong adaptability,widely used for diagnosing pulmonary lesions.To effectively control and eliminate potential confounding factors unrelated to CT-guided PLB(such as age and underlying diseases),a prospective cohort study was conducted,including patients who underwent CT-guided PLB at Beijing Hospital from 2017 to 2023.Baseline clinical and technical data of the patients were compared,and multifactorial logistic regression analysis was employed to identify the technical factors related to the occurrence of pneumothorax.Results Data from our center indicated that the incidence of pneumothorax associated with CT-guided PLB was 21.4%.Among 1 732 patients,those who experienced pneumothorax(371 cases)were compared with those who did not(1 361 cases).The pneumothorax group had a significantly higher average age(68.4 years±8.2 years vs 60.1 years±10.5 years,P＜0.001).Additionally,the rates of emphysema or bullae(27.0%vs 22.1%,P=0.005),lesion size≤2 cm(13.5%vs 10.1%,P＜0.001),distance from the chest wall≥2 cm(73.0%vs 62.5%,P=0.016),bronchial involvement(48.5%vs 16.3%,P=0.002),and needle insertion depth≥5 cm(59.6%vs 44.6%,P＜0.001)were significantly higher in the pneumothorax group compared to the non-pneumothorax group.Multifactorial logistic regression analysis revealed that two technical factors:distance from the lesion to the chest wall≥2cm(OR=1.341,95%CI:1.065-1.687,P=0.017)and needle insertion depth≥5 cm(OR=1.362,95%CI:1.077-1.726,P=0.012),along with two clinical factors:presence of bullae or emphysema(OR=1.583,95%CI:1.084-2.314,P=0.020)and lesion size≤2 cm(OR=1.364,95%CI:1.093-1.699,P=0.007),were significant influencing factors for the occurrence of pneumothorax.Conclusions During CT-guided PLB,there are two technical factors and two clinical factors that influence the occurrence of pneumothorax in patients.Based on these results,it is recommended to conduct individualized assessments in clinical practice to reduce the incidence of pneumothorax and improve treatment outcomes for patients.关键词
CT/肺穿刺活检/气胸/技术因素/预后Key words
CT/lung biopsy/pneumothorax/technical factor/prognosis分类
医药卫生引用本文复制引用
别志欣,郭润碛,李彬,王承恩,徐圣,李元明,李晓光..CT引导肺穿刺活检技术发生气胸风险及相关技术因素分析[J].北京生物医学工程,2024,43(6):634-640,7.基金项目
中国医学科学院临床与转化医学研究专项2023资助 （）
