To Analyze The Risk Factors Of Pulmonary Hemorrhage Associated With CT-guided Percutaneous Transthoracic Lung Biopsy

Objective(s):Pulmonary hemorrhage(with or without hemoptysis)is the second most common complication during or after CT-guided percutaneous transthoracic lung biopsy(PTLB),and can even be life-threatening in severe cases.Therefore,to help clinical work more accurately evaluate the risk of PTLB associated pulmonary hemorrhage(with or without hemoptysis).The aim of this study was to identify the risk factors associated with pulmonary hemorrhage and hemoptysis after PTLB.Methods:Patients with lung lesions detected by chest CT examination in our hospital from January 2019 to December 2021 were selected,and CT-guided lung biopsy was performed at the same time.Demographic characteristics such as gender,age,past medical history,hospitalization records,technical parameters of lung biopsy,chest CT related vascular parameters and other data were collected.SPSS 26.0 was used for statistical analysis.Results:1.In the overall pulmonary hemorrhage group,Pulmonary hemorrhage was associated with age,gender,history of chronic bronchitis,history of diabetes,history of hypertension,history of smoking,history of drinking,preoperative use of anticoagulant/antiplatelet drugs,preoperative use of glucocorticoids,malignant or non-malignant pathological type,APTT>40s,PT>16s,platelet<60*10~9/L,needle angle<90°or≥90°,and needle insertion There were no significant differences in the variables of needle site,puncture lesion location,m PAD<2.95cm or≥2.95cm,m PAD/AAD≤1 or>1,m PAD/DAD≤1.12 or>1.12,AAD,DAD,RPAD and LPAD(P>0.05).2.In the overall pulmonary hemorrhage group,history of COPD(P=0.010,OR=3.529,95%CI:1.360-9.162),puncture depth>5cm(P=0.007,OR=4.062,95%CI:1.455-11.340),gender:Female(P=0.042,OR=1.722,95%CI:1.020-2.908)was an independent risk factor for overall pulmonary hemorrhage.Lesion size<3cm(P=0.000,OR=2.857,95%CI:1.693-4.820),number of needle tracks≥2(P=0.000,OR=4.949,95%CI:2.292-10.686),and puncture depth 3-5cm(P=0.000,OR=2.842),95%CI:1.596-5.061)were significant independent risk factors for overall pulmonary hemorrhage.3.In the high-grade pulmonary hemorrhage group,High-grade pulmonary hemorrhage was associated with age,gender,history of chronic bronchitis,history of diabetes,history of hypertension,history of smoking,history of drinking,preoperative use of anticoagulant/antiplatelet drugs,preoperative use of glucocorticoids,malignant or non-malignant pathological type,APTT>40s,PT>16s,platelet<60*10~9/L,lesion size≤3cm or>3cm,needle insertion Angle<90°or≥90°,needle insertion site,puncture lesion location,m PAD<2.95cm or≥2.95cm,m PAD/AAD≤1 or>1,m PAD/DAD≤1.12 or>1.12,AAD,DAD,RPAD and LPAD variables were not related.The difference was not statistically significant(P>0.05).4.In the high-grade pulmonary hemorrhage group,The number of needles≥2(P=0.026,OR=2.911,95%CI:1.139-7.442),puncture depth>5cm(P=0.025,OR=4.115,95%CI:1.195-14.174),preoperativeuseof anticoagulants/antiplatelet drugs(P=0.037,OR=8.373,P=0.037,OR=8.373,P=0.025,OR=4.115,95%CI:1.195-14.174),95%CI:1.131-61.991)were independent risk factors for high-grade pulmonary hemorrhage.5.In the hemoptysis group,Hemoptysis was associated with age,gender,history of chronic bronchitis,COPD,diabetes,hypertension,smoking,drinking,preoperative use of glucocorticoids,malignant or non-malignant pathological type,APTT>40s,PT>16s,platelet<60*10~9/L,lesion size≤3cm or>3cm,number of needle tracts,and needle Angle The variables of<90°or≥90°,insertion site,puncture lesion location,puncture depth,m PAD<2.95cm or≥2.95cm,m PAD/AAD≤1 or>1,m PAD/DAD≤1.12 or>1.12,AAD,DAD,RPAD and LPAD were not statistically significant(p>0.05).6.In the hemoptysis group,preoperative use of anticoagulant/antiplatelet drugs(P=0.002,OR=31.406,95%CI:3.613-272.990)was an independent risk factor for hemoptysis.Conclusion(s):1.The smaller the lesion,the more needle channels and the deeper the puncture depth,the greater the risk of pulmonary hemorrhage in PTLB.2.The greater the number of needle paths and the deeper the puncture depth,the greater the risk of PTLB high-grade pulmonary hemorrhage with preoperative anticoagulant/antiplatelet drugs.3.Preoperative use of anticoagulants/antiplatelet agents for PTLB increased the risk of hemoptysis.