Department of Thoracic Diseases, Health Sciences University Faculty of Medicine, İzmir, Türkiye.
Clinic of Thoracic Diseases, Dr Suat Seren Chest Diseases and Surgery Training and Research Hospital, University of Health Sciences, İzmir, Türkiye.
Tuberk Toraks. 2023 Mar;71(1):67-74. doi: 10.5578/tt.20239909.
The purpose of this study is to determine how long patients who developed pneumothorax were followed up on in the emergency department, how many patients required chest tube placement, and what factors influenced the need for a chest tube in patients who underwent computed tomography (CT)-guided percutaneous transthoracic fine needle aspiration biopsy (PTFNAB).
Patients who developed pneumothorax following CT-guided PTFNAB were analyzed retrospectively. In cases with pneumothorax, the relationship between chest tube placement and the size of the lesion, the lesion depth from the pleural surface, the presence of emphysema, and the needle entry angle were investigated. It was determined how long the patients were followed up in the emergency department, when a chest tube was placed, and when patients who did not require chest tube placement were discharged.
CT-guided PTFNAB was performed in 3426 patients within two years. Pneumothorax developed in 314 (9%) cases and a chest tube was placed in 117 (37%). The risk factor for chest tube placement was found to be the lesion depth from the pleural surface. The lesion depth from the pleural surface of >24 mm increased the risk of chest tube placement by 4.8 times. Chest tubes were placed at an average of five hours (5.04 ± 5.57).
This study has shown that in cases with pneumothorax that required chest tube placement, the lesion depth from the pleural surface is a risk factor. Patients who developed pneumothorax on CT during the procedure had chest tubes placed after an average of five hours.
本研究旨在确定在急诊科接受 CT 引导下经皮经胸细针抽吸活检（PTFNAB）后发生气胸的患者的随访时间，需要放置胸腔引流管的患者人数，以及哪些因素影响需要进行胸腔引流管的患者 CT 引导下经皮经胸细针抽吸活检。
回顾性分析 CT 引导下 PTFNAB 后发生气胸的患者。在气胸的情况下，研究了胸腔引流管放置与病变大小、病变从胸膜表面的深度、肺气肿的存在以及针进入角度之间的关系。确定了在急诊科的随访时间、放置胸腔引流管的时间以及不需要放置胸腔引流管的患者出院的时间。
在两年内对 3426 名患者进行了 CT 引导下 PTFNAB。314 例（9%）发生气胸，117 例（37%）放置胸腔引流管。胸腔引流管放置的危险因素是病变从胸膜表面的深度。病变从胸膜表面的深度>24mm 会使胸腔引流管放置的风险增加 4.8 倍。胸腔引流管平均放置 5 小时（5.04±5.57）。
本研究表明，在需要胸腔引流管放置的气胸病例中，病变从胸膜表面的深度是一个危险因素。在手术过程中 CT 上出现气胸的患者平均在 5 小时后放置胸腔引流管。
