Mačionis Aurimas, Maziliauskienė Gertrūda, Dubeikaitė Rūta, Vajauskas Donatas, Adukauskienė Dalia, Nedzelskienė Irena, Žemaitis Marius
Department of Radiology, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania.
Department of Intensive Care, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania.
Diagnostics (Basel). 2024 Nov 22;14(23):2631. doi: 10.3390/diagnostics14232631.
Complications, particularly pneumothorax, are common following lung interventions and occasionally necessitate further examinations, extend hospital stays, increase treatment costs, and result in long-term health impairment or even death. A few lung intervention tract sealants have been explored to reduce procedure-related complications. The primary objective of this prospective non-randomized study was to assess the complication rates and risk factors for computed tomography-guided lung microwave ablation (MWA) with autologous blood clot as a tract sealant. Twenty-one patients underwent a total of 26 MWA sessions for lung malignancy followed by injection of the patient's clotted venous blood into the ablation tract while retracting the coaxial needle. Ablation tract sealing was successful in all MWA sessions. Pneumothorax was the only complication observed in five (19.2%) sessions, with one patient (3.8%) requiring chest tube insertion. The male sex was a statistically significant risk factor for pneumothorax ( = 0.042), and patients with lung emphysema had almost fivefold higher odds of developing pneumothorax (OR 4.8; 95% CI, 0.617-37.351; = 0.281). This study concludes that pneumothorax is the primary complication following lung MWA, and the male sex is a risk factor. Ablation tract sealing with autologous venous blood is a straightforward and inexpensive technique that can reduce the incidence of procedure-related pneumothorax.
并发症，尤其是气胸，在肺部介入治疗后很常见，偶尔需要进一步检查、延长住院时间、增加治疗费用，并导致长期健康损害甚至死亡。已经探索了一些肺部介入通道密封剂以减少与手术相关的并发症。这项前瞻性非随机研究的主要目的是评估以自体血凝块作为通道密封剂的计算机断层扫描引导下肺微波消融（MWA）的并发症发生率和危险因素。21例患者共接受了26次针对肺恶性肿瘤的MWA治疗，随后在拔出同轴针时将患者的静脉凝血注入消融通道。所有MWA治疗的消融通道密封均成功。气胸是在5次（19.2%）治疗中观察到的唯一并发症，1例患者（3.8%）需要插入胸管。男性是气胸的统计学显著危险因素（ = 0.042），肺气肿患者发生气胸的几率几乎高出五倍（OR 4.8；95% CI，0.617 - 37.351； = 0.281）。本研究得出结论，气胸是肺MWA后的主要并发症，男性是危险因素。用自体静脉血进行消融通道密封是一种简单且廉价的技术，可降低与手术相关气胸的发生率。
