关键词: 肺部CT, 穿刺活检术, 术后并发症, 影响因素

Abstract:

Objective To investigate the current status of complications after computer tomography (CT)-guided lung biopsy and identify related factors. Methods This retrospective study collected clinical data from 184 patients who underwent elective CT-guided lung biopsy at Guangshan County People’s Hospital from March 2023 to March 2025. No patients were lost to follow-up during the study period. Postoperative complications were recorded. Patients were grouped according to the occurrence of postoperative pneumothorax or bleeding, and basic patient characteristics were collected to evaluate the factors influencing postoperative pneumothorax and bleeding after CT-guided lung biopsy. Results Among the 184 patients, 79 developed postoperative complications, with an overall complication rate of 42.93%. These included 45 cases of pneumothorax (24.46%), 38 cases of bleeding-related complications (20.65%), 5 cases of pleural reaction (2.72%), and 10 cases of puncture-site infection (5.43%). Multivariate logistic regression analysis showed that needle length through lung tissue, comorbid chronic obstructive pulmonary disease, lesion maximum diameter ≤20 mm, preoperative residual volume/total lung capacity ratio (RV/TLC%), preoperative forced vital capacity (FVC), forced expiratory volume in 1 second as a percentage of predicted value (FEV1%), and peak expiratory flow (PEF) were all independent risk factors for postoperative pneumothorax (P<0.05). Lesion maximum diameter ≤20 mm, needle length through lung tissue, puncture needle angle with the pleura <40°, and preoperative diffusing capacity for carbon monoxide as a percentage of predicted value (DLCO%) were independent risk factors for postoperative bleeding after CT-guided lung biopsy (P<0.05). Conclusion Postoperative complications such as pneumothorax and bleeding are relatively common after CT-guided lung biopsy. Comorbid chronic obstructive pulmonary disease, lesion maximum diameter ≤20 mm, needle length through lung tissue, and low preoperative pulmonary function parameters (FVC, FEV1%, PEF, RV/TLC%) are the main factors associated with postoperative pneumothorax. In contrast, lesion maximum diameter ≤20 mm, puncture needle angle with the pleura <40°, needle length through lung tissue, and high preoperative DLCO% are the main factors associated with postoperative bleeding. Targeted interventions based on these risk factors may help reduce postoperative complication risk and improve prognosis.

Key words: lung CT, biopsy, postoperative complication, influencing factor