CAJ | 학술논문

目的：分析在CT引导下使用18 G-Bard Magnum活检针在经皮肺穿刺活检中并发症发生的相关因素。方法 CT引导下使用18 G-Bard Magnum活检针经皮肺穿刺活检58例，观察术后并发症发生情况，分析其发生的相关因素。结果58例全部穿刺成功，技术成功率100％。术后发生肺出血11例(19.0％)，包括针道少许出血7例(12.1％)，咯血3例(5.2％)，血性胸水1例(1.7％)；气胸10例(17.2％)。χ2检验表明肺出血与病灶的直径、病灶与胸壁间的距离、病灶的位置及穿刺次数显著相关(P＜0.05)；气胸与年龄、病灶与胸壁间的距离、病灶周围气肿、病灶的位置及穿刺次数显著相关(P＜0.05)。单因素比较分析发现：灶周气肿、病灶位于肺门、具有2个以上危险因素术后易发生并发症(P＜0.05)。结论 CT引导下使用18 G-Bard Magnum经皮肺穿刺活检是一种定位准确、安全性相对较高、阳性诊断率高的检查方法，对于灶周气肿、病灶位于肺门、具有2个以上危险因素者应慎重。
목적：분석재CT인도하사용18 G-Bard Magnum활검침재경피폐천자활검중병발증발생적상관인소。방법 CT인도하사용18 G-Bard Magnum활검침경피폐천자활검58례，관찰술후병발증발생정황，분석기발생적상관인소。결과58례전부천자성공，기술성공솔100％。술후발생폐출혈11례(19.0％)，포괄침도소허출혈7례(12.1％)，각혈3례(5.2％)，혈성흉수1례(1.7％)；기흉10례(17.2％)。χ2검험표명폐출혈여병조적직경、병조여흉벽간적거리、병조적위치급천자차수현저상관(P＜0.05)；기흉여년령、병조여흉벽간적거리、병조주위기종、병조적위치급천자차수현저상관(P＜0.05)。단인소비교분석발현：조주기종、병조위우폐문、구유2개이상위험인소술후역발생병발증(P＜0.05)。결론 CT인도하사용18 G-Bard Magnum경피폐천자활검시일충정위준학、안전성상대교고、양성진단솔고적검사방법，대우조주기종、병조위우폐문、구유2개이상위험인소자응신중。
Objective To analyze the factors related to the occurrence of complications in performing CT-guided percutaneous lung biopsy with 18 G-Bard Magnum needle. Methods CT-guided percutaneous lung biopsy with 18 G-Bard Magnum needle was carried out in a total of 58 patients. The postoperative complications were recorded, and the related factors causing complication were analyzed. Results Successful puncturing was achieved in all patients with a technical success rate of 100%. Postoperative complications included pulmonary hemorrhage (n=11,19.0%), a little amount of bleeding in needle tract (n=7,12.1%), hemoptysis (n=3,5.2%), hemothorax (n=1,1.7%), and pneumothorax (n=10,17.2%). Chi-square test showed that the occurrence of pulmonary hemorrhage bore a close relationship to the lesion’s diameter, the distance between the lesion and the chest wall, the lesion’s location and times of puncturing (P<0.05). The occurrence of pneumothorax was closely correlated with the age, the distance between the lesion and the chest wall, the presence of perifocal emphysema, the lesion’s location and times of puncturing (P<0.05). Univariate analysis indicated that the postoperative complications were liable to occur in the patients whose imaging examination showed perifocal emphysema and lung hilar lesion, and who had more than two independent risk factors (P<0.05). Conclusion CT-guided percutaneous lung biopsy with 18 G-Bard Magnum needle is an accurate and safe technique with relatively higher positive diagnosis rate, but this technique should be carefully used in patients who has perifocal emphysema, or lung hilar lesion, or more than two independent risk factors.(J Intervent Radiol, 2015, 24:792-796)