Department of Radiation Oncology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, 107 Wenhuaxi Road, Jinan 250012, Shandong, China.
Department of Radiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, 107 Wenhuaxi Road, Jinan 250012, Shandong, China.
Can Respir J. 2022 Aug 5;2022:5238177. doi: 10.1155/2022/5238177. eCollection 2022.
The aim of this study was to analyze the differences in risk factors for pulmonary hemorrhage in elderly and young patients with percutaneous computed tomography-guided needle biopsies (PCNBs). The correlations between the incidence of pulmonary hemorrhage and pulmonary function indicators before CT-guided PCNB were also discussed.
Between January 2018 and December 2019, 1,100 consecutive patients underwent CT-guided PCNBs at Qilu Hospital. Both univariate and multivariate logistic regression analyses identified risk factors for hemorrhage.
The occurrence of pulmonary hemorrhage was 22.1% in elderly patients and was 22.6% in young patients. In elderly patients, pulmonary hemorrhage was significantly influenced by needle depth to the lesion and dwell time, while in young patients, pulmonary hemorrhage was independently associated with lesion size, needle depth to the lesion, and dwell time. However, pulmonary function parameters, including FVC (% pred), FEV (% pred), FEV/FVC ratio (%), small airway function parameters (FEF, FEF, and FEF), and large airway function parameters (MVV, PEF, and FEF), were not risk factors for hemorrhage. Furthermore, the incidence of pulmonary hemorrhage was not associated with different types of pulmonary dysfunctions. The risk of pulmonary hemorrhage did not increase with the severity of pulmonary dysfunctions.
In this study, age is no longer a risk factor in evaluating pulmonary hemorrhage. Longer needle depth to the lesion and longer dwell time were significantly high risk factors of hemorrhage in both elderly patients and young patients. Patients with severe pulmonary dysfunctions did not show increased risks of pulmonary hemorrhage here.
本研究旨在分析经皮 CT 引导下穿刺活检（PCNB）的老年和年轻患者发生肺出血的危险因素的差异。并探讨 CT 引导下 PCNB 前肺功能指标与肺出血发生率的相关性。
2018 年 1 月至 2019 年 12 月，1100 例连续患者在齐鲁医院行 CT 引导下 PCNB。采用单因素和多因素逻辑回归分析确定出血的危险因素。
老年患者肺出血发生率为 22.1%，年轻患者为 22.6%。在老年患者中，肺出血明显受针尖至病灶深度和停留时间的影响，而在年轻患者中，肺出血与病灶大小、针尖至病灶深度和停留时间独立相关。然而，肺功能参数，包括 FVC（%预测值）、FEV（%预测值）、FEV/FVC 比值（%）、小气道功能参数（FEF、FEF 及 FEF）和大气道功能参数（MVV、PEF 和 FEF）均不是出血的危险因素。此外，肺出血的发生率与不同类型的肺功能障碍无关。肺出血的风险与肺功能障碍的严重程度无关。
在这项研究中，年龄不再是评估肺出血的危险因素。针尖至病灶的深度和停留时间较长是老年和年轻患者发生肺出血的显著高危因素。严重肺功能障碍的患者在此并未显示出增加肺出血的风险。
