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目的:统计CT导引下经皮肺穿刺切割活检(ACNB)术后并发症并分析影响因素。方法:回顾性总结352例胸膜外定位法(EPL)ACNB结果,对主要并发症出血及气胸相关因素行多因素非条件Logistic回归分析。结果:活检准确率为94.9%,每例操作时间为(16.0±2.0)min。出血率22.7%,咯血率5.1%,Logistic分析提示肺不张(OR值0.321)为保护因素。气胸率17.0%,迟发性气胸1.4%,封闭引流率0.6%,Logistic分析提示合并慢性阻塞性肺疾病(COPD)(OR值11.224)及病灶直径(OR值2.556)是气胸发生的危险因素。出血并气胸率6.0%。胸膜反应及术后持续性疼痛各1例。严重并发症率1.4%。结论:CT导引下EPL法ACNB诊断准确率高,出血及气胸是主要并发症,合并肺不张出血率低,合并COPD及病灶直径小气胸率高,要警惕迟发性并发症及严重并发症的发生。
OBJECTIVE: To analyze postoperative complications of CT guided percutaneous puncture biopsy (ACNB) and analyze the influencing factors. Methods: 352 cases of EPL ACNB were retrospectively reviewed. Multivariable non-conditional logistic regression analysis was performed on major complication bleeding and pneumothorax-related factors. Results: The accuracy of biopsy was 94.9% and the operation time was (16.0 ± 2.0) min. Bleeding rate was 22.7% and hemoptysis rate was 5.1%. Logistic analysis suggested atelectasis (OR 0.321) as protective factor. Pneumothorax rate was 17.0%, delayed pneumothorax rate 1.4% and closed drainage rate 0.6%. Logistic analysis indicated that COPD (OR = 11.224) and lesion diameter (OR = 2.556) were the risk factors of pneumothorax. Bleeding and pneumothorax rate of 6.0%. Pleural reaction and postoperative persistent pain in 1 case. Serious complication rate 1.4%. Conclusion: Computed tomography (EPL) -based ACPL method has the advantages of high diagnostic accuracy, hemorrhage and pneumothorax are the main complication, combined with low atemorrhagic rate of atelectasis, combined with COPD and lesion diameter pneumothorax rate, to guard against late complications and severe complications Occurrence of the disease.