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目的探讨 CT 导向下经皮肺穿刺活检术气胸形成因素之间的关系。方法对283例肺部病变患者在 CT 导向下行经皮肺穿刺活检术,分析气胸发生因素的作用及因素间的关系,并提出相应的预防措施和处理方法。结果 283例患者肺部病变穿刺均获成功,发生气胸32例,除3例气胸量较大外,其余均为少量气胸。气胸发生与操作者穿刺技术、患者自身状况、病灶因素、麻醉因素以及穿刺针的粗细等因素有关。少量气胸无需处理,大量气胸需置管引流。结论 CT 导向下经皮肺穿刺活检术气胸形成的影响因素之间具有相关性,操作者穿刺技术熟练程度是气胸形成与否的主要因素,患者自身状况、病灶因素、麻醉因素以及穿刺针的粗细等是次要相关因素。
Objective To explore the relationship between pneumothorax factors and percutaneous lung biopsy under CT guidance. Methods Percutaneous lung biopsy was performed in 283 patients with pulmonary lesion guided by CT. The effect of pneumothorax and the relationship between the factors were analyzed, and corresponding preventive measures and treatment methods were proposed. Results All the 283 patients were successful in puncture of pulmonary lesion. There were 32 cases of pneumothorax. Except for 3 cases with larger pneumothorax, the rest were a small amount of pneumothorax. Pneumothorax and operator puncture technique, the patient’s own condition, lesions, anesthesia factors and the thickness of the puncture needle and other factors. No need to deal with a small amount of pneumothorax, a large number of pneumothorax need to catheter drainage. Conclusion CT-guided percutaneous lung biopsy has a correlation between the influencing factors of pneumothorax formation. The proficiency of the puncture technique of the operator is the main factor of the formation or absence of pneumothorax. The status of patients, the lesions, the anesthetic factors and the thickness of the needle Is the second most relevant factor.