Incidence of and Risk Factors for Pneumothorax and Chest Tube Placement After CT Fluoroscopy-Guided Percutaneous Lung Biopsy: Retrospective Analysis of the Procedures Conducted Over a 9-Year Period
Incidence of and Risk Factors for Pneumothorax and Chest Tube Placement After CT Fluoroscopy-Guided Percutaneous Lung Biopsy: Retrospective Analysis of the Procedures Conducted Over a 9-Year Period
复制标题
DOI：
10.2214/ajr.09.3224
复制
发表时间：
2010-03-01
影响因子：
5
通讯作者：
Kanazawa, Susumu
中科院分区：
文献类型：
--
作者：
Hiraki, Takao;Mimura, Hidefumi;Kanazawa, Susumu
客观的。我们研究的目的是回顾性评估 CT 透视引导下肺活检后气胸和胸管置入的发生率和危险因素。材料和方法。我们分析了使用 20 号同轴切割针对 1,033 名患者的 1,155 个病变进行的 1,098 次 CT 透视引导肺活检。除了评估气胸和胸管放置的发生率外，还采用多因素Logistic回归分析确定了气胸和气胸胸管放置的独立危险因素。 结果。气胸的总发生率为42.3%（464/1,098）。 11.9% (55/464) 的气胸需要置入胸管（占手术总数的 5.0% [55/1,098]）。气胸的显着独立危险因素是既往没有进行过肺部手术（p = 0.001）、下叶病变（p < 0.001）、病变深度较大（p < 0.001）和针轨迹角度 < 45 度（p = 0.014）；因气胸而放置胸管的患者为肺气肿（p < 0.001）和更大的病变深度（p < 0.001）。 结论。气胸经常发生，CT透视引导下肺活检后偶尔出现气胸，需要放置胸管。为了降低因气胸而需要放置胸管的风险，医生应采用最短的进针路径到达病变部位。
OBJECTIVE. The objective of our study was to retrospectively evaluate the incidence of and the risk factors for pneumothorax and chest tube placement after CT fluoroscopy-guided lung biopsy.MATERIALS AND METHODS. We analyzed 1,098 CT fluoroscopy-guided lung biopsies conducted with 20-gauge coaxial cutting needles for 1,155 lesions in 1,033 patients. Apart from evaluating the incidence of pneumothorax and chest tube placement, the independent risk factors for pneumothorax and chest tube placement for pneumothorax were determined using multivariate logistic regression analysis.RESULTS. The overall incidence of pneumothorax was 42.3% (464/1,098). Chest tube placement was required for 11.9% (55/464) of pneumothoraces (5.0% [55/1,098] of the total number of procedures). The significant independent risk factors for pneumothorax were no prior pulmonary surgery (p = 0.001), lesions in the lower lobe (p < 0.001), greater lesion depth (p < 0.001), and a needle trajectory angle of < 45 degrees (p = 0.014); those for chest tube placement for pneumothorax were pulmonary emphysema (p < 0.001) and greater lesion depth (p < 0.001).CONCLUSION. Pneumothorax frequently occurred and placement of a chest tube was occasionally required for pneumothorax after CT fluoroscopy-guided lung biopsy. To reduce the risk of pneumothorax necessitating chest tube placement, physicians should adopt the shortest needle path to the lesion.