本文選題：肺結(jié)節(jié) + CT引導(dǎo)　； 參考：《介入放射學(xué)雜志》2017年07期

【摘要】：目的探討CT引導(dǎo)下經(jīng)皮穿刺肺實(shí)性結(jié)節(jié)切割活檢術(shù)后并發(fā)出血、氣胸的危險(xiǎn)因素。方法回顧性分析肺實(shí)性結(jié)節(jié)(≤3 cm)320例經(jīng)16 G半自動(dòng)切割活檢的臨床及影像學(xué)資料,行單因素和多因素Logistic回歸分析。結(jié)果活檢術(shù)后針道出血發(fā)生率33.1%,氣胸發(fā)生率18.1%,良惡性診斷準(zhǔn)確率約99.6%。針道長(zhǎng)度是出血的獨(dú)立危險(xiǎn)因素,針道每增加3 cm,風(fēng)險(xiǎn)增加3.881倍,且風(fēng)險(xiǎn)也隨穿刺時(shí)間(P=0.061)和穿胸膜次數(shù)(P=0.062)呈正相關(guān)。年齡、位置和針-胸膜夾角是氣胸獨(dú)立風(fēng)險(xiǎn)因素,年齡每增加10歲,風(fēng)險(xiǎn)增加2.102倍;上肺葉病灶顯著低于下肺葉;針-胸膜夾角每增加20°,風(fēng)險(xiǎn)增加2.413倍,肺氣腫以微弱差距(P=0.086)被排除方程之外。以出血、氣胸概率值繪制ROC曲線,AUC值分別為0.753和0.725。結(jié)論 CT引導(dǎo)下肺實(shí)性結(jié)節(jié)切割活檢術(shù)后出血、氣胸的發(fā)生受多種因素影響,術(shù)前仔細(xì)評(píng)估,術(shù)中操作熟練度可以有效預(yù)判和降低出血、氣胸的發(fā)生。
[Abstract]:Objective to investigate the risk factors of hemorrhage and pneumothorax after percutaneous puncture biopsy of pulmonary solid nodules under CT guidance. Methods Retrospective analysis of the clinical and imaging data of 320 cases of pulmonary solid nodules (less than 3 cm) by 16 G semi-automatic cutting biopsy, and the analysis of single factor and multiple factor Logistic return. Results the incidence of needle bleeding after biopsy was 33.1%. The incidence of pneumothorax was 18.1%. The accuracy of the benign and malignant diagnosis of 99.6%. needle path was an independent risk factor for bleeding, with an increase of 3.881 times the risk of 3 cm in the needle path, and the risk also had a positive correlation with the puncture time (P=0.061) and the number of pleural times (P=0.062). Age, position and needle pleura angle were independent risk factors for pneumothorax, and the age was increased by 10 years of age. The risk increased 2.102 times; upper lobe lesions were significantly lower than that of the lower lobe; the needle - pleura angle increased by 20 degrees, the risk increased by 2.413 times, and the emphysema was excluded by a weak gap (P=0.086). The ROC curve was drawn with the probability of hemorrhage and pneumothorax, and the AUC value was 0.753 and 0.725., respectively, after CT guided pulmonary solid nodule biopsy bleeding, pneumothorax The incidence of bleeding and pneumothorax can be effectively predicted and evaluated by careful preoperative evaluation and intraoperative proficiency.
【作者單位】： 第三軍醫(yī)大學(xué)西南醫(yī)院介入科;
【分類號(hào)】：R563;R816.41

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