超声引导下经皮肺外周病变穿刺活检并发肺出血的危险因素分析

Risk factors of lung hemorrhage complicating ultrasound-guided percutaneous peripheral lung lesions biopsy

目的分析超声引导下经皮肺外周病变穿刺活检相关肺出血的危险因素。方法回顾性分析236例单发肺外周病变患者的临床资料及穿刺活检资料,分析超声引导穿刺活检并发肺出血的危险因素。结果超声引导肺外周病变穿刺活检的成功率为99.58%(235/236),病理确诊率为85.11%(200/235)。穿刺活检相关肺出血发生率为11.91%(28/235)。病变血流显示较丰富与不丰富者相比,穿刺后有无肺出血的差异有统计学意义(P=0.041),而不同性别、年龄、病变位置、病灶前后径、病理类型、病变内支气管征、穿刺针型号及进针次数的患者,穿刺后有无肺出血的差异均无统计学意义(P均>0.05)。结论病变的血流显示是否较丰富与超声引导下经皮肺外周病变穿刺引起肺出血关系密切,术前详细了解病变内血管数量及其走行、分布,有助于减少肺出血的发生。

Objective To analyze the risk factors of lung hemorrhage complicating ultrasound-guided percutaneous peripheral lung lesions biopsy.Methods The clinical and puncture biopsy data of 236 patients with lung peripheral lesions were retrospectively studied,and the risk factors of ultrasound-guided percutaneous biopsy-related lung hemorrhage were analyzed.Results The success rate of ultrasound-guided percutaneous lung peripheral lesions biopsy was 99.58%（235/236）,the rate of pathologic diagnosis was 85.11%（200/235）.The incidence of biopsy-related lung hemorrhage was11.91%（28/235）.Between patients with lesions which had rich blood flow or not,the difference of detection rate on biopsy-related pulmonary hemorrhage was statistically significant（P=0.041）.However,there was no significant difference of gender,age,the location of the lesions,anterior-posterior diameter of lesions,pathologic type,air bronchogram sign,the model of puncture needle and number of needle puncture between patients with and without biopsy-related pulmonary hemorrhage（P〈0.05）.Conclusion Relatively rich color blood flow signal of lesion is closely related to the biopsy-related lung hemorrhage.Understanding the number of lesions＇ blood vessels and their orientation and distribution in detail before biopsy is helpful to reduce the occurrence of lung hemorrhage.