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病例报告:3例经皮经胸针吸活检术后并发脓胸

Case Report: Empyema secondary to percutaneous transthoracic needle biopsy in three cases.

作者信息

Du Rao, Mao Hui, Li Wei Min, Liu Dan, Wang Kaige

机构信息

Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.

Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China.

出版信息

Front Med (Lausanne). 2025 May 16;12:1531909. doi: 10.3389/fmed.2025.1531909. eCollection 2025.

Abstract

Percutaneous transthoracic needle biopsy (PTNB) is a widely utilized diagnostic procedure for pulmonary lesions, with the current literature predominantly documenting pneumothorax and hemorrhage as primary complications. While empyema represents a rare complication, its clinical implications warrant special attention. In this study, we report the cases of three patients with unidentified pulmonary masses who developed empyema after PTNB. All cases exhibited fever (24-48 h post-procedure) and radiographic evidence of pleural effusion progression shortly after the procedure, which was successfully managed through pleural drainage and antibiotic treatment. These findings suggest that pre-procedural infectious foci may be prone to iatrogenic pleural seeding during PTNB. This report emphasizes the necessity of monitoring infectious indicators in patients undergoing biopsy of cavitary or necrotic lesions. Physicians should exercise caution when puncturing lumps suspected of abscesses and remain vigilant for empyema secondary to PTNB if the patient shows signs of infection.

摘要

经皮经胸针吸活检术(PTNB)是一种广泛应用于肺部病变的诊断方法,目前的文献主要记录气胸和出血为主要并发症。虽然脓胸是一种罕见的并发症,但其临床意义值得特别关注。在本研究中,我们报告了3例不明肺部肿块患者在PTNB后发生脓胸的病例。所有病例均在术后24 - 48小时出现发热,术后不久影像学显示胸腔积液进展,通过胸腔引流和抗生素治疗成功处理。这些发现表明,术前感染灶在PTNB期间可能易于发生医源性胸膜播散。本报告强调了对空洞性或坏死性病变活检患者监测感染指标的必要性。医生在穿刺疑似脓肿的肿块时应谨慎,并在患者出现感染迹象时警惕PTNB继发的脓胸。

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