CT引导下经皮纵隔病变活检穿刺路径的策略探究

The Study on the Strategy of CT-Guided Percutaneous Mediastinal Lesion Biopsy Path

目的从安全性探究CT引导下经皮纵隔病变活检穿刺路径的抉择。方法搜集2016年1月至2018年12月在本院行CT引导下经皮纵隔穿刺活检的患者临床资料,按照经皮活检时穿刺针是否过肺将患者分成穿刺不过肺(A组)和穿刺过肺(B组)两组,比较两组穿刺术后并发症发生率。结果 255例患者行CT引导下经皮纵隔穿刺活检术,A组148例,并发症为胸腔出血2例(1.45%);B组107例,其并发症有咯血1例(0.7%)、胸腔出血7例(4.7%)、气胸9例(6.1%)、肺内出血14例(9.5%)。两组的并发症在肺内出血和气胸有明显差异,在咯血和胸腔出血无统计学意义。结论 CT引导下经皮纵隔穿刺活检术安全有效,且穿刺路径不过肺组较过肺组更安全。

Objective To investigate the choice of puncture path for percutaneous mediastinal lesion biopsy guided by CT.Methods The clinical data of patients undergoing percutaneous mediastinal biopsy guided by CT underwent CT in our hospital from January 2016 to December 2018 were retrospectively reviewed.According to whether the needle was transpulmonized during percutaneous biopsy,the patients were divided into group A(puncture but not lung)and group B(puncture through the lungs)two groups,comparing the incidence of complications after puncture.Results A total of 255 patients underwent CT-guided percutaneous mediastinal biopsy.The 148 patients in group A had a complication of 1.45%(2/148)of thoracic hemorrhage and 107 patients in group B.The complications were hemoptysis 0.7%(1/107),thoracic hemorrhage 4.7%(7/107),pneumothorax 6.1%(9/107),and intrapulmonary hemorrhage 9.5%(14/107).Complications in both groups were significantly different between intrapulmonary hemorrhage and pneumothorax.Difference in hemoptysis and thoracic hemorrhage was not statistically significant.Conclusion CT-guided percutaneous mediastinal biopsy is safe and effective,and the puncture path is safer than the lung group.