Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905.
Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN.
AJR Am J Roentgenol. 2019 Oct;213(4):755-761. doi: 10.2214/AJR.19.21248. Epub 2019 Jul 9.
The purpose of this study was to evaluate the prevalence and severity of pain reported during image-guided percutaneous biopsies and to identify factors associated with increased reported pain. In this retrospective study, a database of adult patients who underwent CT- or ultrasound-guided percutaneous core needle biopsy between July 22, 2013, and February 1, 2018, was reviewed. Data collected included patient age and sex, biopsy site, biopsy type (lesion or parenchymal), needle gauge, number of passes, use of sedation, and whether it was the patient's first recorded biopsy. The maximum procedure-related pain reported on a 0-10 numeric rating scale was recorded. Multivariable logistic regression with generalized estimating equations was used to assess the association between covariates and patient-reported pain. A total of 13,344 biopsy procedures were performed in 10,474 patients. Patients reported no pain (0 of 10 scale) during 9765 (73.2%) procedures. Female sex, younger age at biopsy, undergoing IV sedation, and larger needle diameter were all associated with increases in patient-reported pain. Biopsies of renal allografts were the least likely to be painful, followed by hepatic allografts. Patients typically report mild or no pain from image-guided biopsy performed by radiologists. Younger patients and women report greater pain. This information can assist preprocedural counseling and reassurance of patients and may help them predict procedure-related patient needs.
本研究旨在评估在影像引导经皮活检过程中报告的疼痛的发生率和严重程度，并确定与报告疼痛增加相关的因素。 在这项回顾性研究中，对 2013 年 7 月 22 日至 2018 年 2 月 1 日期间接受 CT 或超声引导经皮核心针活检的成年患者的数据库进行了回顾。收集的数据包括患者年龄和性别、活检部位、活检类型（病变或实质）、针规、穿刺次数、镇静的使用情况以及是否为患者首次记录的活检。记录了患者报告的 0-10 数字评分量表上的最大与程序相关的疼痛程度。使用广义估计方程的多变量逻辑回归来评估协变量与患者报告的疼痛之间的关联。 在 10474 名患者中进行了 13344 次活检。在 9765 次（73.2%）手术中，患者报告无疼痛（0 分）。女性、活检时年龄较小、接受 IV 镇静和更大的针直径都与患者报告的疼痛增加有关。 肾移植的活检最不可能引起疼痛，其次是肝移植。 放射科医生进行的影像引导活检，患者通常报告轻度或无疼痛。年轻患者和女性报告的疼痛更大。这些信息可以帮助进行术前咨询，并使患者感到安心，也有助于他们预测与手术相关的患者需求。
