,. 5 CT 7 respectively 65.% (7 / 669),.% ( / 669) and 9.% (6 / 669), accounting for 97.% of total complications in lung (65 / 669). One patient had ai

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1 6 The Journal of Evidence-Based Medicine Dec. Vol. No.6 5 CT a, a, a, b, a (, a. ; b., 58) [ ] CT, 5 CT, 5 5, 7 (7.5%); 68 (5.%), 65 (.57%), 7 (.65%) 5, 669 (.% ); 579 (9.%), 6 (.8%), 7 (.89%) 5, 5 (.5%); 9 (.6%), (.8%) 669, 65.% (7 / 669).%( / 669)9.%(6 / 669) ( ) 97.%(65 / 669), ;, CT, [ ] CT ; ; [ ] R86 [ ] A DOI:.969 / j.issn Cases of CT-Guided Percutaneous Needle Biopsy Analysis of Complications and Nursing Key Points YE Zhi-hong a, YANG Wan-qun a, LI Xin-yun a, FANG Liang-yi b, ZHAO Zhen-jun a (a. Department of Radiology, Medical Image; b. Department of Radiotherapy, Guangdong General Hospital,Guangdong Academy of Medical Sciences, Guangzhou 58, China) Abstract: Objective To analyze the complications of large amount cases of percutaneous needle biopsy guided by computed tomography (CT), and probe into measures to reduce serious complications and nursing key points. Methods Retrospective analysis of the complications of 5 cases on percutaneous needle biopsy guided by CT was performed, including the mild, moderate and severe complications. Among them, 5 cases of lung puncture were emphatically analyzed. Results Of the 5 cases of CT-guided percutaneous biopsy, complications occurred in 7 cases (7.5%). Among them, the complications in 68 cases were mild (5.%); in 65 cases were moderate (.57%) and in 7 cases were severe (.65%). In 5 cases of lung puncture, the complications occurred in 669 cases (.%). Among them, the complications in 579 cases were mild (9.%); in 6 cases were moderate (.8% ) and in 7 cases were severe (.89% ). Of the 5 cases of extrapulmonary organs puncture, 5 patients had complications (.5% ), including mild in 9 cases (.6% ); moderate in cases (.8% ). Within the 669 cases of pulmonary complications, the incidences of simple pneumothorax, hemoptysis and pulmonary hemorrhage were [ ] (976-),,,, [ ], Tel: ; junabc6@hotmail.com

2 ,. 5 CT 7 respectively 65.% (7 / 669),.% ( / 669) and 9.% (6 / 669), accounting for 97.% of total complications in lung (65 / 669). One patient had air embolism and one patient was dead. Chronic obstructive pulmonary disease (COPD) was the main risk factor associated with moderate and severe pneumothorax. Increase and enlargement of surrounding blood vessels and piercing damage of the blood vessels around were the main risk factors associated with severe hemoptysis. In addition, air bronchogram within the lesion was also the risk factor associated with severe hemoptysis. Conclusion CT-guided percutaneous needle biopsy was a safe diagnostic method. Careful operation, strict observation and intensive nursing were important measures to prevent and reduce the postoperation complications. Key words: CT-guided needle biopsy; complications; nursing CT,,, 5 ml,,%~% [-5] 9 78,..,, 79 [],,, 5 5 mm, CT CT,,,,%,,,, mm CT (6.%), 85 (5.78%), 67 (88.6%), 79 (.5% ) : 5 (7.89% ), 5 (8.6% ), 7 (6.58% ), 9 (.7% ), 89 (.5% ), 5 (.%), (.6%), (.96%), 8 (.9%), (.77%), ; : 5 (.6%),5 (.6%), 6 (.5%, )... SPSS. CT, t,, χ, α=.5,.. GE Lightspeed CT, 8G Biopince 8G BARD Magnum,, CT, %, ; ml,..,, ; 87, (5±7.), 56 6,,,. : ; :, ; : ml, %,, ( ). []. 5 CT,

3 ,, 669 ; 5, COPD 8.%(5 / 6) ,, 65.%(7 / 669).%( / 669) 9.% (6 / 669), ( ) 97.%, CT, 5%, CT,, 7.6% 6, 5,,,.,9,, (75%,9 / ), 8 (%) (%) (%) (66.67%,8 / ), ,,, CT,,, %,,,,, (65 / 669) 55 ( ),, ~, ICU,,, (%).,,, (%) ,, 7, 8, 5, (chronic obstructive, pulmonary disease,copd), 5 -,, COPD,,

4 .5, COPD,,P<.5 5±6.8 (cm).7±. (cm).6±.6, 55 6,,P< t χ P (n=) (n=7) () () 55±8.7 6± (cm).±.6 (cm).8±.9.6±.5.86± (cm) COPD.8.7 () (cm) : : :, COPD 5.9. : (65 / 669) (.%) CT., 5, 7.5%, 55 ( ), 5%,.65%,.75% [],. 5 CT 9 t (n=9) (n=) χ 6±.76..9± ± (.5%),, (55 / 5), 68%(55 / 669) 9.87%(8 / 55),,, ;6.7%(9 / 55), %,,, 97.%.76%(8 / 55) P

5 5 6 5%~5% [-5],,, cm,,, COPD,,,P<.5, COPD ;,,,COPD, CT, [6],COPD COPD, (6% ), (7%),,,,,,,, - -,,,,,,,,,, 6, %,,. CT,,,, 5 : (),,, ; (), 7.6%( / 5), 6.9% (6 / ), Khan [5],, 8.%(5 / 6) Fish [7],,,, CT 7%,,,, ; (),, ;() % ~, 7% [ -5],,,,,,,P<.5. COPD,,.6%,,, [],,,,, ;,,75%,,,,66.67%

6 ,. 5 CT 5,.%,.7% [8], [ ], [] Tomiyama N, Yasuhara Y, Nakajima Y, et al. CT-guided needle biopsy of lung lesions: A survey of severe complication,, %, based on 978 biopsies in Japan [J]. Eur J Radiol, 6,59, ():6-6.,, CT with pneumothorax and pneumothorax requiring treatment after,, percutaneous lung biopsy in consecutive patients, Vasc Interv Radiol,,5(5):79-8. [J]. J, the risk of pneumothorax and chest Tube placement after percutaneous CT-guided lung biopsy: The angle of the needle,.%,.7% trajectory is a novel predictor [J]. Chest,,(5):5- ~.5% [,9] 56. [] Yeow KM, Su IH, Pan KT, et al. Risk factors of pneumothorax and bleeding: Multivariate analysis of 66 CTguided coaxial cutting needle lung biopsies [J]. Chest,,, 6():78-75.,,, hemorrhage in CT-guided transthoracic biopsy Radiol, 8,8(7):56-6., [J]. Eur [6],,,. CT CT,, 9,(6): , [7] Fish GD, Stanley JH, Miller KS, et al. Postbiopsy pneumothorax: Estimating the risk by chest radiography and pulmonary function tests [J]. AJR, 988,5():7-7. [8] Sinner WN. Complications of percutaneous transthoracic needle aspi-ration biopsy [J]. Acta Radiol Diag, 976,7:8-88. CT [9] Richardson CM, Pointon KS, Manhire AR, et al.,,, Percutaneous lung biopsies: A survey of UK practice based on, 5 biopsies [J]. Br J Radiol,,75(897):7-75. [] [] [5] Covey AM, Gandhi R, Brody LA, et al. Factors associated Saji H, Nakamura H, Tsuchida T, et al. The incidence and Khan MF, Straub R, Moghaddam SR, et al. Variables affecting the risk of pneumothorax and intrapulmonal [J]. ( ), [ ] --6!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! ( 5 ) [7] Thiele H, Sick P, Boudriot E, et al. Randomized comparison Cardiology Meeting, New Orleans. of intra-aortic balloon support with a percutaneous left [] Lemos PA, Cummins P, Lee CH, et al. Usefulness of ventricular assist device in patients with revascularized acute percutaneous left ventricular assistance to support high-risk myocardial infarction complicated by cardiogenic shock [J]. percutaneous coronary interventions [J]. Am J Cardiol,, [8] Eur Heart J, 5,6():76-8. Perera D, Stables R, Thomas M, et al. Elective intra-aortic [] 9():79-8. Burkhoff D, O'Neill W, Brunckhorst C, et al. Feasibility balloon counterpulsation during high-risk percutaneous study of the use of the TandemHeart percutaneous ventricular coronary intervention: A randomized controlled trial [J]. assist device for treatment of cardiogenic shock [J]. Catheter [9] JAMA,,(8): W ON. Prospective Multicenter Trial Comparing Impella.5 to IABP in high risk PCI. Presented at the American College of Cardiovasc Interv, 6,68():-7. [ ] --6

. 一位罹患急性心肌梗塞合併心因性休克患者之護理經驗. 壹前言根據行政院衛生署統計資料, 顯示心臟疾病已躍居台灣地區十大死因前三名, 其中急性心肌梗塞死亡人數為 3

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