CT引导下肺小结节(≤20mm)的同轴穿刺活检技术及并发症分析

Coaxial puncture biopsy technique and complications analysis of CT-guided puncture biopsy for small pulmonary(≤20mm)nodules

目的探讨肺小结节CT引导下行同轴穿刺活检术及相关并发症的影响因素。方法对636例肺小结节(直径≤20mm)行CT引导同轴穿刺活检术的患者,回顾性分析CT引导下同轴肺穿刺活检的并发症与年龄、结节直径、穿刺针过肺深度、调针次数的关系。结果本例636例患者,发生354例出现出血(55.66%),其中12例出现少量咯血(1.89%)无大咯血及大出血发生;132例出现气胸(20.75%),所有气胸患者均未置管引流。统计学分析显示:结节大小、穿刺针过肺深度和调针次数与并发症发生有统计学意义(P≤0.05);年龄不同组之间并发症的发生无统计学意义。结论结节大小、穿刺针过肺深度以及调针次数是影响CT引导下同轴肺穿刺并发症发生率重要因素。

Objective To investigate the risk factors of complications after computed tomography(CT)-guided coaxial puncture biopsy of small pulmonary(≤20mm)nodules.Methods Coaxial puncture biopsy for small pulmonary(≤20mm)nodules were performed in 636 cases.Complications of coaxial puncture biopsy and relationship with age,diameter of the nodule,depth of the target lesion and numbers of puncture were retrospectively analyzed.Results Bleeding presented as lung parenchyma hemorrhage and hemoptysis in 354 patients(55.66%),a small amount of hemoptysis occurred in 12 patients and there were no massive hemoptysis or massive bleeding.Pneumothorax occurred in 132 patients(20.75%),and there was no chest tube insertion needed.Statistical analysis showed that there were significant differences in the sizes of nodule,the depth of nodule,the puncturing numbers and the occurrence of complications(P<0.05).There was no significant difference in the complications among different groups.Conclusion The sizes of nodule,the depth of nodule and puncturing numbers are important factors which affect the incidence of complications caused by CT-guided coaxial puncture small lung nodules.