Miller K S, Fish G B, Stanley J H, Schabel S I
Division of Pulmonary and Critical Care Medicine, University of South Carolina, Charleston, 29425.
Chest. 1988 Apr;93(4):742-5. doi: 10.1378/chest.93.4.742.
Pneumothorax (PTX) is the most common complication associated with percutaneous needle aspiration (PNA) of the lung. Age, sex, cooperation, and lesion size, location, and depth, as well as needle size, number of passes, and radiographic calculation of total lung capacity all have been implicated in influencing the rate of PTX. Pulmonary function testing to assess PTX risk in PNA has not been previously examined. We retrospectively reviewed 159 patients undergoing PNA who had preprocedure spirometry (PFT) and chest roentgenogram (CXR) interpreted for changes of obstruction or restriction to determine if these classifications could stratify patients at high risk for PTX. We also examined single variables to determine their predictive power. Patients with normal PFT and CXR had a 10 percent risk of PTX, and only one such patient needed intervention to treat the PTX. Obstruction by PFT, regardless of CXR findings, predicted a 50 percent PTX rate. Among single variables, FEV1 proved to be the most significant predictor of PTX. Preprocedure spirometric testing can enhance the assessment of PTX risk and should be routinely performed prior to needle aspiration.
气胸（PTX）是经皮肺穿刺抽吸术（PNA）最常见的并发症。年龄、性别、配合程度、病变大小、位置和深度，以及穿刺针尺寸、穿刺次数和通过胸部X线片计算的肺总量均被认为与气胸发生率有关。此前尚未对通过肺功能测试评估PNA中气胸风险进行过研究。我们回顾性分析了159例行PNA的患者，这些患者术前均进行了肺量计检查（PFT）和胸部X线检查（CXR），以判断是否存在阻塞或受限改变，从而确定这些分类能否对气胸高风险患者进行分层。我们还分析了单一变量以确定其预测能力。PFT和CXR均正常的患者发生气胸的风险为10%，且只有1例此类患者需要干预来治疗气胸。无论CXR结果如何，PFT显示阻塞的患者气胸发生率预计为50%。在单一变量中，第一秒用力呼气容积（FEV1）被证明是气胸最显著的预测指标。术前肺量计检查可加强对气胸风险的评估，应在穿刺抽吸术前常规进行。
