不同屏气方法对CT引导下经皮肺穿刺活检效能的影响

A prospective randomized controlled study of the efficacy of different breath-holding methods on CT-guided percutaneous lung biopsy

目的探索不同屏气方法在CT引导下经皮肺穿刺活检中的应用价值。方法采取前瞻性研究,选取2021年1月1日至2021年11月3日就诊于成都市第三人民医院,患有肺部病变的患者320例,采用平静呼吸状态下的吸气末屏气(A组,106例)、随机屏气(B组,104例)及呼气末屏气(C组,110例)三种不同屏气方法,行CT引导下经皮肺穿刺活检。比较三种屏气方法的穿刺成功率、诊断准确率、并发症发生率等差异。结果三组穿刺成功率均为100%,诊断准确率三组间差异无统计学意义(P>0.05);A、B、C三组并发症总体发生率分别为43.4%、50%、58.2%。三组间肺出血发生率差异无统计学意义(P>0.05);气胸和咯血发生率差异有统计学意义(P<0.05),且A组气胸和咯血发生率与B、C两组比较差异有统计学意义(P<0.05)。对于中下叶的病灶,A组气胸发生率较低,与B、C两组比较差异有统计学意义(P<0.05)。结论CT引导下经皮肺穿刺活检中,采用平静呼吸状态下吸气末屏气相对于其他屏气方法可减少并发症的发生。

Objective To investigate the application value of different breath-holding methods in CT-guided percutaneous lung biopsy.Method We adopted a prospective study of 320 patients,who were hospitalized in the Third People's Hospital of Chengdu after January1,2021 and planned to undergo CT-guided percutaneous lung puncture.In this study,three different breath-holding methods were used:end-inspiratory breath-hold(group A),random breath-hold(group B)and end-expiratory breath-hold(group C)under the state of calm breathing.We compared the success rate,diagnostic accuracy and complication rate of three breath-holding methods in CT-guided percutaneous lung biopsy.Results The success rate of CT-guided percutaneous lung biopsy was 100%in the three groups,there was no significant difference in the diagnostic accuracy among the three groups(P>0.05).The overall incidence of complications in groups A,B,and C were 43.4%,50%,and 58.2%,respectively.There was no statistical difference in the incidence of pulmonary hemorrhage among the three groups(P>0.05).There were significant differences in the incidence of pneumothorax and hemoptysis among the three groups(P<0.05),and the incidence of pneumothorax and hemoptysis in group A was significantly different from that in groups B and C(P<0.05).For lesions in the middle and lower lobes,the incidence of pneumothorax in group A was lower,and there was a statistically significant difference between groups B and C(P<0.05).Conclusion Compared with other breath-hold methods,the use of endinspiratory breath-hold in calm breathing state in CT-guided percutaneous lung biopsy can reduce the incidence of complications.