小视野扫描方法在CT引导下经皮穿刺活检肺小结节中的应用及对气胸、肺内出血发生率的影响

Application of small FOV scanning method in CT-guided percutaneous biopsy of small pulmonary nodules and its influences on the incidences of pneumothorax and intrapulmonary hemorrhage

目的研究小视野(FOV)扫描方法在CT引导下经皮穿刺活检肺小结节中的应用及对气胸、肺内出血发生率的影响。方法回顾性分析2019年4月至2020年3月本院收治的102例肺小结节患者的临床资料,患者均开展CT引导下经皮穿刺活检。分析影响CT引导下经皮穿刺活检肺小结节中发生气胸和肺内出血的危险因素。结果穿刺次数、穿刺时间、结节长径是影响气胸发生的独立危险因素(P<0.05);穿刺次数、穿刺时间、扫描方法、结节长径、病变沿针道距胸膜的距离为影响肺内出血发生的独立危险因素(P<0.05)。结论在CT引导下经皮穿刺活检肺小结节中穿刺次数、穿刺时间、结节长径、FOV大小、病变沿针道距胸膜的距离会导致气胸、肺内出血等并发症的发生,临床应积极控制穿刺次数和穿刺时间,调整病变沿针道距胸膜的距离,应用小FOV扫描有助于降低肺内出血等并发症发生率。

Objective To study the application of small field of view(FOV)scanning method in CT-guided percutaneous biopsy of small pulmonary nodules and its influences on the incidences of pneumothorax and intrapulmonary hemorrhage.Methods Clinical data of 102 patients with small pulmonary nodules admitted in our hospital from April 2019 to March 2020 were retrospectively analyzed,and all patients underwent CT-guided percutaneous biopsy.The risk factors of pneumothorax and intrapulmonary hemorrhage in CT-guided percutaneous biopsy of small pulmonary nodules were analyzed.Results The number of puncture,puncture time and nodule length were the independent risk factors affecting pneumothorax(P<0.05);number of puncture,puncture time,scanning method,nodule length and the distance from the lesion along the needle path to the pleura were the independent risk factors affecting intrapulmonary hemorrhage(P<0.05).Conclusion In CT-guided percutaneous biopsy of small pulmonary nodules,number of puncture,puncture time,nodule length,FOV size,the distance from the lesion along the needle path to the pleura can lead to complications such as pneumothorax and intrapulmonary hemorrhage.In clinical practice,the number of puncture and puncture time should be controlled actively,the distance from the lesion along the needle path to the pleura should be adjusted,and the application of small FOV scan is helpful to reduce the incidence of complications such as pulmonary hemorrhage.