CT引导下经皮肺穿刺活检术后并发出血的原因及护理策略

The reason of postoperative hemorrhage and nursing strategy under CT-guided percutaneous lung puncture biopsy

目的 探讨CT引导下经皮肺穿刺活检术后并发出血的原因及其护理策略。方法 回顾性分析2015年7月至2017年12月在山东省青岛市胸科医院行CT引导下经皮肺穿刺活检术后并发出血的100例肺部占位性病变患者的临床资料,将患者的年龄、性别、肿物大小、肿物深度、病灶周围炎症、穿刺次数、穿刺时间及肺部慢性病变等因素分成不同的等级资料并行单因素χ2分析,对筛选后的结果行logistics多因素回归分析。结果 单因素χ2分析结果显示,不同年龄、性别、穿刺次数、穿刺时间及有无肺部慢性病变的患者CT引导下经皮肺穿刺活检术后并发出血的发生率差异无显著性(P>0.05),而不同肿物大小、肿物深度及病灶周围有无炎症的患者CT引导下经皮肺穿刺活检术后并发出血的发生率差异有显著性(P<0.05);多因素logistics回归分析结果显示,肿物大小(OR=0.124,95%CI0.025~0.62,P=0.011)、肿物深度(OR=0.086,95%CI0.023~0.324,P=0.000)及病灶周围炎症(OR=0.119,95%CI0.017~0.821,P=0.031)是穿刺术后并发出血的独立危险因素。结论 CT引导下经皮肺穿刺活检术后并发出血与肿物大小、深度及病灶周围炎症有关,应熟练掌握操作技术,进行针对性的护理干预,以降低穿刺术后并发出血的风险。

Objective To explore the causes and nursing strategies of hemorrhage after CT-guided percutaneous lung puncture biopsy.Method A retrospective analysis of 100 cases of CT guided percutaneous lung biopsy by bleeding after lung space-occupying lesions in patients with clinical data,the patient’s age,sex,tumor size,tumor depth and surrounding inflammation,puncture times,the time of puncture,and factors related to chronic lung diseases were divided into different levels of data parallel univariate chi-square analysis,the results of screening line Logistics multifactor regression analysis.Result Single factorχ2 analysis results show that the concurrent cases of bleeding after paracentesis in age,gender,number of puncture,puncture differences between groups in terms of time and the presence of chronic lung diseases had no statistical significance(P>0.05),and around the tumor size,tumor depth,and presence of lesions inflammation comparison between groups,differences were significant(P<0.05).Multivariate regression analysis showed that mass size,mass depth,and inflammation around lesions were independent risk factors for hemorrhage after puncture(P<0.05).Conclusion The occurrence of postoperative hemorrhage after CT-guided percutaneous lung puncture biopsy is related to the depth and size of the mass,as well as the presence of inflammation around the lesion.