老年人肺穿刺活检并发症探讨

Investigation of complications of pneumocentesis biopsy in the elderly

目的 观察老年人与非老年人肺穿刺活检肺组织出血和气胸的发生情况。方法CT定位下选用18G半自动槽式切割活检针，经皮经肺穿刺取材进行细胞学、组织学病理检查。297例患者根据年龄分为老年组（175例）和非老年组（122例），观察术后病理结果，比较两组发生气胸、出血等并发症情况。结果297例中发生气胸108例（36．4％），老年组76例（43．4％），非老年组32例（26．2％），两组比较差异有统计学意义（X2=9．19，P〈0．01）。气胸程度两组比较，差异无统计学意义（均P〉0．05）。肺组织出血156例（52．5％），其中老年组105例（60．0％），非老年组51例（41．8％），两组比较差异有统计学意义（x2=9．55，P〈0．01）。片状出血比较，差异有统计学意义（X2=20．28，P〈O．01）。两组无气胸和出血与气胸并存出血比较，差异有统计学意义（X2=值分别为18．41、9．04，均P〈0．01）。结论老年人肺穿刺活检成功率与非老年组无差异，但发生气胸和较大程度的出血高于非老年组。

Objective To investigate the difference in occurrence of pneumothorax and bleeding under lung biopsy between the elderly and the non-elderly. Methods A total of 297 consecutive patients were involved in the study and divided into nonelderly group （〈60 yrs, 122 cases）, and elderly group （≥60 yrs, 175 cases）. Eighteen-gauge （18G） cutting needles were used for biopsy with computed tomography （CT） guidance. Biopsy samples were detected by histology and cytology pathology. Results Pneumothorax occured in 108 of 297 biopsies （36.4%）, pneumothorax rate was higher in elderly group （76 cases, 43.4%） than in non-elderly group（32 cases, 26.%） （X2 = 9.19,P〈0.01）. No statistical significance was found in different degrees of pneumothorax between the two groups. Perifocal hemorrhage oceured in 156 of 297 biopsies （52.50/40）, higher frequency of hemorrhage occurred in elderly group （105 cases, 60.0%） than in non-elderly group（51 cases, 41.8%）（X2=9.55,P〈0.01）, and the more flake bleeding was found in elderly group than in nonelderly group（x2 =20.28,P〈0.01）. Conclusions In CT-guided coaxial cutting needle biopsy, the incidence of pneumothorax and considerably bleeding are higher in the elderly than in non-elderly.