Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Osaka, Japan.
Department of High Precision Image-guided Percutaneous Intervention, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Osaka, Japan.
BMC Pulm Med. 2024 Oct 10;24(1):505. doi: 10.1186/s12890-024-03315-z.
Computed tomography (CT)-guided lung biopsy is a widely used technique for the diagnosis of pulmonary lesions and with a high technical success rate and diagnostic accuracy. On the other hand, it is associated with a high risk of complications, especially pneumothorax. Various methods have been tried to reduce the incidence of pneumothorax, but no established method exists. The purpose of this study was to evaluate whether the combination of tract sealing with normal saline and rapid rollover can reduce the rate of pneumothorax and chest tube insertion after CT-guided lung biopsy.
We reviewed all CT-guided lung biopsies performed at a single institution between October 2016 and December 2021. Before August 2019, no specific additional techniques were employed to mitigate complications (Group 1). In contrast, after September 2019, normal saline for tract sealing was injected during needle removal, and if pneumothorax was observed during the intervention, the patient was rolled over into the puncture-site down position immediately after needle removal (Group 2). The rate of complications was compared between the two groups.
130 patients in Group 1 and 173 in Group 2 were evaluated. There was no significant difference in pneumothorax rate between the two groups (30.0% vs. 23.1%, P = .177). A chest tube was inserted in 10 of 130 patients in Group 1 and only in 1 of 173 in Group 2 (P = .001). There were no complications associated with this combinational technique.
The combination of normal saline injection and rapid rollover significantly reduced the incidence of pneumothorax requiring chest tube insertion after CT-guided lung biopsy. Therefore, normal saline injection and rapid rollover can serve as a preventive method for severe pneumothorax in CT-guided lung biopsy.
计算机断层扫描（CT）引导下肺活检是一种广泛用于诊断肺部病变的技术，具有较高的技术成功率和诊断准确性。另一方面，它与较高的并发症风险相关，尤其是气胸。已经尝试了各种方法来降低气胸的发生率，但目前还没有确定的方法。本研究旨在评估 CT 引导下肺活检中，使用生理盐水联合快速翻身的方法是否可以降低气胸和胸腔引流管插入的发生率。
我们回顾了 2016 年 10 月至 2021 年 12 月期间在一家机构进行的所有 CT 引导下肺活检。在 2019 年 8 月之前，没有采用特定的额外技术来减轻并发症（组 1）。相反，在 2019 年 9 月之后，在拔针时注入生理盐水进行路径密封，如果在介入过程中观察到气胸，在拔针后立即将患者翻转为穿刺部位朝下的位置（组 2）。比较两组并发症的发生率。
在组 1 中评估了 130 例患者，在组 2 中评估了 173 例患者。两组气胸发生率无显著差异（30.0%比 23.1%，P=0.177）。在组 1 中有 10 例患者需要插入胸腔引流管，而在组 2 中仅有 1 例患者需要插入（P=0.001）。没有与这种联合技术相关的并发症。
在 CT 引导下肺活检中，生理盐水注射和快速翻身的联合应用显著降低了需要胸腔引流管插入的气胸发生率。因此，生理盐水注射和快速翻身可以作为 CT 引导下肺活检中严重气胸的预防方法。
