摘要
目的评估CT引导下经皮肺穿刺的安全性及其影响因素,获得并发症发生的预测方程。方法回顾性分析上海交通大学医学院附属瑞金医院2002年3月至2009年7月进行CT引导下经皮肺穿刺的住院患者。总结患者临床特征、影像学特征和并发症发生情况,评估并发症的影响因素,并通过Logistic多元回归获得并发症发生的预测方程。结果共入选281例次CT引导下经皮肺穿刺,其中157例出现并发症,包括气胸91例(32.4%)、出血97例(34.5%)、皮下气肿6例(2.1%)。气胸相关的独立危险因素有:病变所在肺叶、病变深度、穿过胸膜次数。出血相关的独立危险因素有:患者年龄、病变大小、病变深度。通过Logistic多元回归分别获得预测气胸和出血发生可能的两个预测方程,气胸预测方程的敏感度为80.0%,特异度为62.4%,出血预测方程的敏感度为67.4%,特异度为88.8%。结论病变所在肺叶、病变深度、穿过胸膜次数是气胸的独立危险因素,患者年龄、病变大小、病变深度是出血的独立危险因素。通过Logistic多元回归获得的气胸和出血预测方程,有助于预先评估患者CT引导下经皮肺穿刺发生并发症的风险,以利于减少并发症。
Objective To evaluate the complication rate of CT-guided percutaneous lung biopsy and determine the risk factors.Methods A retrospective investigation of patients with CT-guided percutaneous lung biopsy in Ruijin Hospital,Shanghai Jiao Tong University School of Medicine between 2002 and 2009 was performed.The risk factors for complications were determined by multivariate analysis of variables related to patients' demographics,lung lesions,biopsy procedures,and individual radiological features.Results 281 biopsy procedures were enrolled.The total complication rate was 55.9% with pneumothorax 32.4%(91/281),hemoptysis 34.5%(97/281),and cutaneous emphysema 2.1%(6/281),and with no mortality.The pneumothorax rate was correlated with lesion location,lesion depth,and number of pleural passes.The bleeding risk was correlated with lesion size,lesion depth,and age.Prediction models for pneumothorax and bleeding were deduced by logistic regression.The pneumothorax model had a sensitivity of 80.0% and a specificity of 62.4%.And the bleeding model had a sensitivity of 67.4% and a specificity of 88.8%.Conclusions Lesion location,lesion depth,and number of pleural passes were independent risk factors for pneumothorax.Lesion size,lesion depth,and age were independent risk factors for bleeding.The prediction models for pneumothorax and bleeding will helpfully reduce the complication of CT-guided lung biopsy.
出处
《中国呼吸与危重监护杂志》
CAS
2011年第2期162-167,共6页
Chinese Journal of Respiratory and Critical Care Medicine
