Vitulo P, Dore R, Cerveri I, Tinelli C, Cremaschi P
Division of Pneumology, University of Pavia, Italy.
Chest. 1996 Mar;109(3):612-5. doi: 10.1378/chest.109.3.612.
In 243 of 945 patients having lung percutaneous needle biopsy, we retrospectively evaluated 10 independent variables that potentially influence the incidence of pneumothorax (PNX): age, sex, lesion size, number of needle passes, needle intrapulmonary route, distance of the lesion from the chest wall, FEV1, FVC, residual volume, and total lung capacity percent predicted. The subjects considered (mean age, 61 years; 192 men and 51 women) performed respiratory function tests within 1 year of the procedure. The sample was also subdivided into four functional groups: restricted patients, obstructed ones, obstructed with alveolar hyperinflation patients, and normal subjects. The variables significantly correlated to PNX were the length of the needle intraparenchymal route (p<0.05) and the distance of the lesion from chest wall greater than 0 cm (p<0.01). None of the functional parameters was determinant in predicting PNX occurrence. Bronchial obstruction was not significantly associated with a higher risk of PNX. Nevertheless, when alveolar hyperinflation was associated with bronchial obstruction, the risk increased significantly (odds ratio, 2.38).
在945例行肺经皮穿刺活检的患者中，我们回顾性评估了10个可能影响气胸（PNX）发生率的独立变量：年龄、性别、病变大小、穿刺针数、针在肺内的路径、病变距胸壁的距离、第1秒用力呼气容积（FEV1）、用力肺活量（FVC）、残气量以及预计总肺容量百分比。纳入的研究对象（平均年龄61岁；男性192例，女性51例）在操作前1年内进行了呼吸功能测试。样本还被分为四个功能组：限制性通气患者、阻塞性通气患者、合并肺泡过度充气的阻塞性通气患者以及正常受试者。与PNX显著相关的变量是针在实质内的路径长度（p<0.05）以及病变距胸壁的距离大于0 cm（p<0.01）。没有一个功能参数能决定PNX的发生。支气管阻塞与PNX的较高风险无显著相关性。然而，当肺泡过度充气合并支气管阻塞时，风险显著增加（优势比，2.38）。
