针吸肺活检并发气胸与各种危险因素的关系探讨

Risks of pneumothorax in transthoracic needle aspiration biopsy of the lung

目的 探讨经胸针吸肺活检 (TNAB)并发气胸与各种危险因素的关系。方法 对 42 4例符合穿刺指征患者予同样的方法行经胸针吸肺活检 ,分析患者年龄、性别 ,穿刺针的直径 ,病灶的直径、深度、肺叶位置和患者肺功能与气胸的关系。结果 出现气胸 43例 ,发生率 10 .1%。年龄与气胸发生有关 ,气胸组平均年龄高于无气胸组 (P <0 .0 1) ,直径小的病灶增加气胸发生率 (P<0 .0 1)。位置深的病灶增加气胸发生率 (P <0 .0 1)。气胸组FEV1 %、FEV1 /FVC比率低于无气胸组 (P <0 .0 1) ,穿刺针的外径粗细与气胸发生率有关 ,外径粗气胸发生率高 (P <0 .0 5 )。结论 年龄、病灶直径和深度、肺功能和穿刺针直径与经胸针吸肺活检并发气胸有关 ,术前予肺功能检测是必要的。

Objective To determine the risk factors for the rate of pneumothorax associated with TNAB of the lung. Methods This study involved 424 consecutive patients who underwent TNAB in our hospital under consistent methods. Patient age,sex,needle size,lesion size,distance of lesion from the pleura and results of pulmonary function tests were analyzed as single variables for pneumothorax. Results Forty-three patients had pneumothorax (10.1%) after TNAB. Age associated with higher rate of pneumothorax ( P <0.01). Increased lesion depth was a significant predictor of pneumothorax ( P <0.01). Smaller lesion size was correlated with increased risk of pneumothorax ( P <0.01). The FEV 1%、FEV 1/FVC ratio were lower in patients with pneumothorax ( P <0.01). Needle size was also correlated with increased risk of pneumothorax (P=0.0397).Conclusion Age,increased lesion depth and smaller lesion size,needle size and PFTs are correlated strongly with the development of pneumothorax. Our findings suggest that PFTs is necessary to perform in all patients prior to biopsy.