Comparison Of The Clinical Application Of Two Cutting Biopsy Needies In CT-guided Percutaneous Lung Biopsy

Objective:The application of two kinds of cutting biopsy needles in CT-guided percutaneous lung biopsy was compared to evaluate the differences between the two in diagnostic accuracy and complication rate,and to explore the risk factors for pneumothorax in CPLB.Methods:A total of 414 patients who underwent CT-guided percutaneous lung biopsy in the second affiliated Hospital of Chongqing Medical University from January 2014 to June 2019 were divided into two groups:Super-core TM needle group（n=209）and BARD Magnum needle group（n=205）.The clinical data of these patients were recorded,and the treatment and survival of the patients were followed up.The collected data are analyzed and processed by SPSS22.0,and the statistical results are obtained.Results:（1）There were no significant differences in diagnostic accuracy,specificity and sensitivity between the two kinds of biopsy needles（P>0.05）;（2）The sample sufficiency rate of Bard Magnum needle group was significantly higher than that of Super-Core ^TMneedle group（98%vs 89%,P<0.05）;（3）Compared with the BARD Magnum needle,the Super-core TM needle demonstrated a higher pulmonary hemorrhage rate（42.6%vs 26.3%;P=0.001）and pneumothorax rate（34.4%vs 23.4%;P=0.013）,and a lower hemoptysis rate（15.3%vs27.3%;P=0.003）;（4）Among the pulmonary space occupying lesions larger than 3cm,the incidence of pneumothorax（40.0%vs 24.0%）and pulmonary hemorrhage（54.0%vs 22.1%;P<0.05）in Super-core TM needle group were significantly higher than that in BARD Magnum needle group;（5）The independent risk factors for affecting the occurrence of pneumothorax in CPLB were lesions in the right middle lobe（odds ratio[OR],2.600;95%CI,1.096-6.166;P=0.030）and the depth of from the lesion to the pleural surface greater than 10mm（OR,2.394,95%CI,1.308-4.384;P=0.005）.Conclusion:The two kinds of cutting needles have the advantages of good safety,high diagnostic accuracy and high sample adequacy.The semi-automatic cutting needle should be selected for lung space-occupying lesions less than or equal to 3cm,and full-automatic cutting needle should be selected for lung space-occupying lesions larger than 3cm.The univariate and multivariate Logistic regression analysis showed that lesions with increased depth and located in the right middle lobe were the independent risk factors for pneumothorax under CT-guided percutaneous lung biopsy.