活检相反体位穿刺抽气治疗CT引导下肺穿刺活检所致气胸

目的探讨采用与活检相反体位穿刺抽气对治疗CT引导下肺穿刺活检并发气胸的意义。方法收集CT引导下经皮肺穿刺活检术后并发气胸并接受抽气治疗的102例患者,观察比较单纯抽气与单纯抽气+与活检相反体位穿刺抽气对治疗肺穿刺术后并发气胸的效果。结果 102例接受单纯抽气治疗的患者中,72例(72/102,70.59%)患者单纯抽吸治疗有效,其中18例完全缓解,54例部分缓解;30例(30/102,29.41%)单纯抽气无效,采用与活检相反体后穿刺抽气,其中8例完全缓解,20例部分缓解,2例患者抽气治疗失败而转采用胸腔置管术;改进抽气治疗方法后,抽气治疗气胸总有效率由70.59%(72/102)上升至98.04%(100/102)。结论采用单纯抽气+与活检相反体位穿刺抽气可以有效治疗CT引导下肺穿刺活检术后发生的气胸,从而减少使用胸腔置管术,为一种安全、有效的气胸微创处理方法。

Opposite position for aspiration in treatment of pneumothorax following CT-guided lung biopsy

Objective To evaluate the efficacy of opposite position for aspiration in treatment of pneumothorax following CT-guided lung biopsy. Methods Totally 102 pneumothorax patients who had undergone CT-guided percutaneous core biopsies were enrolled. The efficacy of simple manual aspiration and using the opposite position for aspiration were observed. Results All of those patients were treated with simple aspiration firstly and 72 patients (72/102, 70.59%) were effective. The cases of complete regression and partial regression were 18, 54 respectively. In the other 30 patients (30/102, 29.41%), simple aspiration was ineffective. An opposite position (from prone to supine or vice versa) was applied to perform another aspiration and 8 patients were complete regression and 20 were partial regression. Two cases underwent chest tube placement. Applying the improved method, the total effective rate of 70.59% (72/102) were elevated to 98.04% (100/102). Conclusion Using the opposite position for aspiration could be effective in treatment for pneumothorax following CT-guided lung biopsy, and it can reduce the use of chest tube especially in persistent pneumothorax. It is a safe and effective minimally invasive treatment for pneumothorax.