Poe R H, Kallay M C, Wicks C M, Odoroff C L
Chest. 1984 Feb;85(2):232-5. doi: 10.1378/chest.85.2.232.
We prospectively studied results of 103 consecutive transthoracic needle biopsies of lung lesions suspicious for malignancy to determine if lesion size, depth within the lung, hyperinflation, second needle passes, or 100 percent oxygen breathing influenced the incidence of pneumothorax. Thirty-eight patients (37 percent) developed pneumothorax. Ten (10 percent) required tube thoracostomy for re-expansion. Five of the ten requiring the chest tube had clinically severe obstructive lung disease. In all patients, greater depth (D) in centimeters of needle penetration significantly increased the probability (p) of pneumothorax (p much less than .001) and can be estimated by the equation: (formula see text) The estimated probability of pneumothorax is 13 percent at 1 cm, 49 percent at 4 cm, and 86 percent at 7 cm. An increase in total lung capacity above predicted added additional risk of pneumothorax (p less than .02). Oxygen breathing did not significantly reduce the incidence of pneumothorax, but may reduce size by increasing the rate of reabsorption. The other factors had little influence. We conclude that the more central location of the lesion and pre-existing lung hyperinflation determine the risk of pneumothorax.
我们对103例连续的经胸针吸活检进行前瞻性研究，这些活检针对疑似恶性的肺部病变，以确定病变大小、在肺内的深度、肺过度充气、第二次进针或吸入100%氧气是否会影响气胸的发生率。38例患者（37%）发生了气胸。10例（10%）需要胸腔闭式引流以促进肺复张。10例需要放置胸管的患者中有5例患有临床严重的阻塞性肺病。在所有患者中，针穿刺深度（以厘米为单位）越大，气胸发生的概率（p）显著增加（p远小于0.001），可通过以下公式估算：（公式见原文）气胸的估计概率在1厘米时为13%，4厘米时为49%，7厘米时为86%。肺总量高于预测值会增加气胸的额外风险（p小于0.02）。吸氧并没有显著降低气胸的发生率，但可能通过提高吸收速率来减小气胸的大小。其他因素影响较小。我们得出结论，病变的更中心位置和预先存在的肺过度充气决定了气胸的风险。
