风险因素与空气栓塞在计算机断层成像指导的皮肤肺活检后的风险因素:一个回顾性病例对照研究
Tingting Wu1, Shuai Li2, Mengyu Gao2
1Department of Health Management, Hubei Cancer Hospital, TongJi Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
PeerJ
|October 21, 2024
概括
在计算机断层扫描 (CT) 引导的皮肤穿越胸腺针活检 (TNB) 期间确定气栓塞的危险因素至关重要. 咳,血,病变特征和刺伤细节是这种并发症的关键预测因素.
科学领域:
- 医学成像和干预性放射学
- 肺部医学 肺部医学
- 在瘤学瘤学.
背景情况:
- 计算机断层扫描 (CT) 引导的皮肤穿越胸腺针活检 (TNB) 是诊断肺病变的常见程序.
- 空气栓塞是TNB的潜在并发症,需要确定相关的危险因素.
- 了解这些风险因素可以改善患者安全和程序结果.
研究的目的:
- 追溯识别和分析CT引导TNB后与气栓塞相关的风险因素.
- 评估空气栓塞发生的已识别因素的预测能力.
主要方法:
- 在两个主要医院接受CT-TNB的32,748名患者的回顾性分析 (2017年1月 - 2021年12月).
- 采集和分析21个潜在的风险因素,使用最小绝对收缩和选择运营商 (LASSO) 回归.
- 使用接收器-操作器特征 (ROC) 曲线对预测能力的评估.
主要成果:
- 观察到2.16%的整体气栓塞发生率 (1.46%在一个医院,0.69%在另一个).
- 只有25%的气栓塞病例有症状;没有死亡.
- 单变量和多变量分析确定了八个显著的风险因素,ROC曲线面积为0.721,表明具有良好的预测能力.
结论:
- 几个因素,包括手术期间的咳,血,靠近肺静脉,病变腔的存在,病变位置,样本数量,凝血异常和穿孔部位,都与气栓塞风险有关.
- 这些发现可以为程序修改提供信息,以减轻CT-TNB中的气栓塞风险.
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