摘要
目的 探讨CT导引下肺内病变穿刺活检影响气胸发生率的因素。资料与方法 回顾复习肺内病变CT导引下穿刺活检 4 38例 ,观察因素包括患者相关因素 (性别、年龄 )、病灶相关因素 (病变的性质、病灶大小、位置、有无空腔 )、操作相关因素 (患者的体位、胸膜穿刺次数、活检所用时间、穿刺路径通过的肺组织有无肺气肿、穿刺路径经过通气肺组织的长度 )。对所有观察因素分别进行单因素和多元逐步Logistic回归分析观察其对气胸发生率的影响。结果 (1) 4 38例中 5 9例 (13.5 % )发生气胸 ,其中 4例 (0 .9% )需胸部导管引流。单因素分析显示病灶大小(F =2 .0 88,P =0 .0 38)、胸膜穿刺次数 (χ2 =34.87,P <0 .0 0 1)、活检所用时间 (F =4 .2 0 9,P <0 .0 0 1)、穿刺路径通过的肺组织有无肺气肿 (χ2 =8.5 0 ,P =0 .0 0 4 )、穿刺路径经过通气肺组织的长度 (F =4 .84 2 ,P <0 .0 0 1)均是影响气胸发生率的相关因素 ;(2 )多元逐步Logistic回归分析显示胸膜穿刺次数 (waldχ2 =18.6 5 4 ,P =0 .0 0 0 1)、穿刺路径通过的肺组织有无肺气肿 (waldχ2 =10 .6 5 9,P =0 .0 0 1)和穿刺路径经过通气肺组织的长度 (waldχ2 =10 .16 9,P =0 .0 0 1)被列入回归方程。结论 胸膜穿刺次数、穿刺路径经过的肺组织有无肺气肿和?
Objective To discuss the factors which influence the frequency of pneumothorax in performing CT guided transthoracic aspiration biopsy for pulmonary lesions.Materials and Methods CT guided transthoracic aspiration biopsy was performed in 438 consecutive patients with pulmonary lesions. The factors related to the patient (sex and age), to the lesion (pathology, size, site, with or without cavity) and to the surgery (patient's posture, number of pleural passes, presence of emphysema in puncturing route and the length of aerated lung traversed) were observed and recorded. The influence of these factors on the frequency of pneumothorax was retrospectively evaluated by using univariate analysis and multivariate stepwise logistic regression analysis.Results (1) Of 438 patients, pneumothorax occurred in 59 (13.5%) and drain tube was required in 4. Univariate analysis indicated that the occurrence of pneumothorax was significantly related to several factors. These factors included the lesion's size (F=2.008, P=0.038), the number of pleural passes (χ 2=34.87, P<0.001), the operation time (F=4.209, P< 0.001), the presence of emphysema in puncturing route (χ 2=8.50, P=0.004) and the length of aerated lung traversed (F= 4.842, P<0.001). (2) Multivatiate stepwise logistic regression analysis showed that only three factors were significantly associated with the occurrence of pneumothorax. The factors included the number of pleural passes (wald χ 2=18.654, P=0.0001), the presence of emphysema in puncturing route (wald χ 2=10.659, P=0.001) and the length of aerated lung traversed (wald χ 2=10.169, P=0.001).Conclusion The number of pleural passes, the presence of emphysema in puncturing route and the length of aerated lung traversed are the main factors influencing the frequency of pneumothorax in performing CT guided transthoracic aspiration biopsy for pulmonary lesions.
出处
《临床放射学杂志》
CSCD
北大核心
2003年第7期582-585,共4页
Journal of Clinical Radiology
