Zhang Xiaoxia, An Jianli, Wu Jingpeng, Jing Xiuxiu, Lu Hongzhi, Tian Ye
Departments of Infectious Diseases.
Interventional Treatment, First Hospital of Qinhuangdao.
J Comput Assist Tomogr. 2025;49(4):640-645. doi: 10.1097/RCT.0000000000001725. Epub 2025 Jan 27.
To confirm that saline sealing of the needle trace after computed tomography (CT)-guided lung biopsy reduces the incidence of pneumothorax and chest tube insertion, and to observe its effects on pulmonary hemorrhage and hemoptysis.
Patients who underwent CT-guided lung biopsy at our hospital between January 2018 and January 2024 were included in the study. Patients were divided into 2 groups according to whether the needle trace was sealed with saline after tissue sampling. Patient baseline characteristics, lung lesion factors, procedural factors, pneumothorax rates, chest tube insertion rates, pulmonary hemorrhage rates, and hemoptysis rates were recorded.
The incidence of pneumothorax was 28.9% (38/132) and 15.8% (15/95) in groups A (control) and B (with sealed traces), respectively ( P =0.002). The incidence of pneumothorax requiring chest tube insertion was significantly lower in group B than in group A (1.1% vs. 6.8%; P =0.048). The incidence of pulmonary hemorrhage was similar between the 2 groups (38.6% vs. 42.1%; P =0.599). No significant difference was observed in the hemoptysis of patients in groups A and B (6.8% vs. 10.5%; P =0.320). In the binary logistic regression analysis, significant risk factors for pneumothorax included lack of saline sealing, smaller lesion size, multiple passes through the pleura, and the lateral decubitus position. Smaller lesions and longer biopsy trace lengths were independent risk factors for hemoptysis.
Sealing the needle trace with saline significantly reduced the incidences of pneumothorax and chest tube insertion due to pneumothorax. Moreover, it did not significantly increase the incidence of pulmonary hemorrhage or hemoptysis. This technique is recommended for use in CT-guided lung biopsies.
证实计算机断层扫描（CT）引导下肺活检后对针道进行生理盐水封闭可降低气胸发生率及胸腔闭式引流管置入率，并观察其对肺出血和咯血的影响。
纳入2018年1月至2024年1月在我院接受CT引导下肺活检的患者。根据组织取样后针道是否用生理盐水封闭将患者分为2组。记录患者基线特征、肺部病变因素、操作因素、气胸发生率、胸腔闭式引流管置入率、肺出血发生率和咯血发生率。
A组（对照组）和气胸发生率分别为28.9%（38/132）和B组（针道封闭组）的15.8%（15/95）（P = 0.002）。B组气胸需要胸腔闭式引流管置入的发生率显著低于A组（1.1%对6.8%；P = 0.048）。两组间肺出血发生率相似（38.6%对42.1%；P = 0.599）。A组和B组患者咯血情况无显著差异（6.8%对10.5%；P = 0.320）。在二元逻辑回归分析中，气胸的显著危险因素包括未用生理盐水封闭、病变较小、多次穿过胸膜和侧卧位。较小的病变和较长的活检针道长度是咯血的独立危险因素。
用生理盐水封闭针道可显著降低气胸发生率及因气胸导致的胸腔闭式引流管置入率。此外，它并未显著增加肺出血或咯血的发生率。推荐该技术用于CT引导下肺活检。
