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经胸CT引导下肺活检联合明胶海绵鱼雷道栓塞术后气胸和胸管置入发生率降低:一项倾向评分匹配研究

Reduced Incidence of Pneumothorax and Chest Tube Placement following Transthoracic CT-Guided Lung Biopsy with Gelatin Sponge Torpedo Track Embolization: A Propensity Score-Matched Study.

作者信息

Feinggumloon Sasikorn, Radchauppanone Panupong, Panpikoon Tanapong, Buangam Chinnarat, Pichitpichatkul Kaewpitcha, Treesit Tharintorn

机构信息

Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.

Chiangrai Prachanukroh Hospital, Chiang Rai 57000, Thailand.

出版信息

J Clin Med. 2024 Aug 9;13(16):4666. doi: 10.3390/jcm13164666.

Abstract

: To evaluate the effectiveness of track embolization using gelatin sponge torpedo in reducing the incidence of pneumothorax and chest tube placement after percutaneous CT-guided lung biopsy. : A retrospective single-center analysis of percutaneous computed tomography (CT)-guided transthoracic lung biopsies was performed between 2017 and 2022. After excluding the patients who received an ultrasound-guided biopsy, combined lung biopsy with ablation, fiducial placement, unsuccessful procedure due to uncooperative patient, and age under 18 years, 884 patients' clinical information was collected (667 without track embolization and 217 with track embolization). The incidence of early and late pneumothorax and chest tube placement were compared between the two groups. Propensity score matching (PSM) was applied to minimize selection bias. Univariable and multivariable analyses were performed to determine risk factors for pneumothorax. : After PSM, the baseline differences and all factors that could affect the incidence of pneumothorax were balanced between the track embolization group (217 patients) and the non-track embolization group (217 patients). The incidence rates of early pneumothorax (13.4% vs. 24.0% = 0.005), late pneumothorax (11.0% vs. 18.0% = 0.021), and chest tube placement (0.9% vs. 4.6% = 0.036) were significantly decreased in the track embolization group. However, the success rate of tissue diagnosis yield and length of hospital stay were not significantly different between the two groups. In multivariate analysis, the risk of pneumothorax increased as the fissure was passed (OR = 3.719, = 0.027). : Using track embolization with a gelatin sponge torpedo significantly decreased the incidence of pneumothorax and chest tube placement following percutaneous CT-guided lung biopsy.

摘要

评估使用明胶海绵鱼雷进行穿刺道栓塞在降低经皮CT引导下肺活检后气胸发生率及胸腔闭式引流管置入率方面的有效性。对2017年至2022年间接受经皮计算机断层扫描(CT)引导下经胸肺活检的患者进行单中心回顾性分析。排除接受超声引导活检、联合肺活检与消融、放置基准标记、因患者不配合导致操作失败以及年龄小于18岁的患者后,收集了884例患者的临床信息(667例未进行穿刺道栓塞,217例进行了穿刺道栓塞)。比较两组患者早期和晚期气胸及胸腔闭式引流管置入的发生率。应用倾向评分匹配(PSM)以最小化选择偏倚。进行单因素和多因素分析以确定气胸的危险因素。PSM后,穿刺道栓塞组(217例患者)和非穿刺道栓塞组(217例患者)之间的基线差异及所有可能影响气胸发生率的因素均达到平衡。穿刺道栓塞组早期气胸发生率(13.4%对24.0%,P = 0.005)、晚期气胸发生率(11.0%对18.0%,P = 0.021)及胸腔闭式引流管置入率(9%对4.6%,P = 0.036)均显著降低。然而,两组间组织诊断成功率及住院时间无显著差异。多因素分析中,穿过肺裂时气胸风险增加(OR = 3.719,P = 0.027)。使用明胶海绵鱼雷进行穿刺道栓塞可显著降低经皮CT引导下肺活检后气胸及胸腔闭式引流管置入的发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24d9/11355364/4ee979bf9375/jcm-13-04666-g001.jpg

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