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自体血注射在降低经皮肺穿刺活检后气胸发生率中的效果。

Effectiveness of autologous blood injection in reducing the rate of pneumothorax after percutaneous lung core needle biopsy.

机构信息

Department of Radiology, University of Health Sciences Konya Training and Research Hospital, Konya, Turkey.

Department of Thoracic Surgery, University of Health Sciences Konya Training and Research Hospital, Konya, Turkey.

出版信息

Diagn Interv Radiol. 2020 Sep;26(5):470-475. doi: 10.5152/dir.2020.19202.

Abstract

PURPOSE

To assess the effectiveness and safety of autologous intraparenchymal blood patch (IBP) application in reducing the frequency of pneumothorax (PTX) after percutaneous transthoracic pulmonary core needle biopsy.

METHODS

The records of patients who underwent the transthoracic pulmonary core needle biopsy procedure under CT guidance between January 2015 and October 2018 were screened retrospectively. Patients whose traversed pulmonary parenchymal length was ≥20 mm during biopsy were included in the study irrespective of lesion size. The IBP procedure was made a department policy in November 2017; patients who underwent biopsy after this date comprised the IBP group, while those who underwent the procedure before this date comprised the control group. IBP recipients received 2-5 mL of autologous blood injection to the needle tract. Demographic data, procedural reports, tomography images, and the follow-up records of patients were assessed.

RESULTS

A total of 262 patients were included in the study. Of the 91 patients that received an IBP, PTX developed in 13 (14.1%), with 7 (7.7%) requiring a thoracic tube. Of the 171 patients who did not receive an IBP, PTX developed in 45 (26.3%), with 19 (11.1%) requiring a thoracic tube. Patients who received an autologous IBP showed a significantly lower rate of PTX development versus those who did not (P = 0.01). Similarly, a significantly lower number of patients who received the blood patch required chest tube placement (P = 0.015).

CONCLUSION

Autologous IBP is a safe, inexpensive and easy to use method that reduces the rate of PTX development and thoracic tube application after percutaneous core needle biopsies of the lung.

摘要

目的

评估自体肺内血补丁(IBP)应用在减少经皮经胸肺核心针活检后气胸(PTX)发生率的有效性和安全性。

方法

回顾性筛选 2015 年 1 月至 2018 年 10 月期间在 CT 引导下行经胸肺核心针活检的患者记录。在活检过程中,无论病变大小,只要穿透的肺实质长度≥20mm,就将患者纳入研究。2017 年 11 月,IBP 程序成为部门政策;在此日期之后接受活检的患者为 IBP 组,而在此日期之前接受该程序的患者为对照组。IBP 接受者将 2-5 毫升的自体血液注入针道。评估了患者的人口统计学数据、程序报告、断层扫描图像和随访记录。

结果

共有 262 例患者纳入研究。在接受 IBP 的 91 例患者中,13 例(14.1%)出现 PTX,其中 7 例(7.7%)需要胸腔引流管。在未接受 IBP 的 171 例患者中,45 例(26.3%)出现 PTX,其中 19 例(11.1%)需要胸腔引流管。接受自体 IBP 的患者与未接受 IBP 的患者相比,PTX 发生率显著降低(P=0.01)。同样,接受血补丁的患者需要放置胸腔引流管的数量也显著减少(P=0.015)。

结论

自体 IBP 是一种安全、廉价且易于使用的方法,可降低经皮肺核心针活检后 PTX 发生率和胸腔引流管应用率。

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