CT引导肺活检后生理盐水针道封堵疗效的系统综述与Meta分析
本研究系统检索Embase、Scopus、PubMed和Cochrane数据库，纳入7项研究共1455例患者，比较CT引导肺活检后生理盐水针道封堵与常规处理的疗效。结果显示，生理盐水针道封堵显著降低气胸发生率（RR 0.46，95%CI 0.32-0.67，p=0.002）和胸管置入率（RR 0.24，95%CI 0.14-0.40，p<0.001）。
要点
- CT引导肺活检后生理盐水针道封堵可显著降低气胸和胸管置入风险。
- 该技术操作简便，值得在日常肺活检中常规采用。
核心结论
- 在CT引导肺活检患者中，与常规处理相比，生理盐水针道封堵显著降低气胸发生率和胸管置入率。
研究设计与样本
- 系统综述与Meta分析，系统检索Embase、Scopus、PubMed和Cochrane数据库。
- 纳入7项研究，共1455例患者，其中680例（46.7%）行生理盐水针道封堵。
- 结局指标为气胸和胸管置入，采用随机效应模型合并风险比（RR）及95%置信区间。
- PROSPERO注册号：CRD420251249441。
诊断标准与关键数值
- 生理盐水针道封堵较常规处理显著降低气胸发生率，RR 0.46，95%CI 0.32-0.67，p=0.002，I²=50%。
- 生理盐水针道封堵较常规处理显著降低胸管置入率，RR 0.24，95%CI 0.14-0.40，p<0.001，I²=0%。
临床应用与阅片要点
- 对CT引导下经皮穿刺肺活检患者，拔针前可经针道注入生理盐水以降低气胸和胸管置入风险。
- 该操作无需额外器械或昂贵材料，适合在日常活检流程中推广。
局限性
- 气胸Meta分析存在中等异质性（I²=50%），可能受纳入研究间操作细节差异影响。
以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。
英文原文（摘要）· 点击展开
INTRODUCTION: CT-guided percutaneous transthoracic lung biopsy is a high-value procedure with risks such as pneumothorax and chest tube placement. Several needle-tract sealing techniques have been proposed to reduce post-biopsy pneumothorax, although evidence regarding saline tract sealing remains limited. This study updated a meta-analysis comparing normal saline tract sealing to usual care for pneumothorax and chest tube placement in guided lung biopsies.
METHODS: Embase, Scopus, PubMed, and Cochrane databases were systematically searched for studies comparing tract instillation with normal saline versus usual care in patients undergoing CT-guided lung biopsy. The outcomes assessed were pneumothorax and chest tube placement. Risk ratios (RR) with 95% confidence intervals (CI) were pooled with a random effects model.
RESULTS: Seven studies were included following our inclusion criteria, comprising a total of 1,455 patients. Of these, 680 patients (46.7%) underwent tract instillation with saline after CT-guided lung biopsy. Compared to usual care, saline tract instillation was associated with significantly lower rates of pneumothorax (risk ratio 0.46; 95% CI 0.32-0.67; p=0.002; I2 = 50%) and chest tube placement (risk ratio 0.24; 95% CI 0.14-0.40; p<0.001; I2 = 0%).
CONCLUSIONS: In patients undergoing CT-guided lung biopsy, tract sealing with normal saline reduces the incidence of pneumothorax and chest tube placement, compared to usual care.
PROSPERO REGISTRATION: CRD420251249441.
引用
- Kayaoglu, Almeida, Varela Betancourt, et al. Efficacy of saline tract sealing after CT-Guided lung biopsy: a systematic review and meta-analysis. Clin Radiol. 2026. PMID: 42322811. doi:10.1016/j.crad.2026.107401
供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。