PDF(Pubmed)
Abstract：
BACKGROUND: Pneumothorax is the most frequent complication after CT-guided percutaneous transthoracic lung biopsy (CT-PTLB). Many studies reported that injection of autologous blood patch (ABP) during biopsy needle withdrawal could reduce the pneumothorax and chest tube insertion rate after CT-PTLB, but the result is debatable. The aim of this systematic review and meta-analysis is to synthesize evidence regarding the efficacy of ABP procedure in patients receiving CT-PTLB.
METHODS: Eligible studies were searched in Pubmed, Embase and Web of Science databases. The inclusion criteria were studies that assessed the relationship between ABP and the pneumothorax and/or chest tube insertion rate after CT-PTLB. Subgroup analyses according to study type, emphysema status and ABP technique applied were also conducted. Odds ratio (OR) with 95% confidence interval (CI) were calculated to examine the risk association.
RESULTS: A total of 10 studies including 3874 patients were qualified for analysis. Our analysis suggested that ABP reduced the pneumothorax (incidence: 20.0% vs. 27.9%, OR = 0.67, 95% CI = 0.48-0.66, P < 0.001) and chest tube insertion rate (incidence: 4.0% vs. 8.0%, OR = 0.47, 95% CI = 0.34-0.65, P < 0.001) after CT-PTLB. Subgroup analysis according to study type (RCT or retrospective study), emphysema status (with or without emphysema), and ABP technique applied (clotted or non-clotted ABP) were also performed and we found ABP reduced the pneumothorax and chest tube insertion rate in all subgroups.
CONCLUSIONS: Our study indicated that the use of ABP was effective technique in reducing the pneumothorax and chest tube insertion rate after CT-PTLB.
METHODS: Eligible studies were searched in Pubmed, Embase and Web of Science databases. The inclusion criteria were studies that assessed the relationship between ABP and the pneumothorax and/or chest tube insertion rate after CT-PTLB. Subgroup analyses according to study type, emphysema status and ABP technique applied were also conducted. Odds ratio (OR) with 95% confidence interval (CI) were calculated to examine the risk association.
RESULTS: A total of 10 studies including 3874 patients were qualified for analysis. Our analysis suggested that ABP reduced the pneumothorax (incidence: 20.0% vs. 27.9%, OR = 0.67, 95% CI = 0.48-0.66, P < 0.001) and chest tube insertion rate (incidence: 4.0% vs. 8.0%, OR = 0.47, 95% CI = 0.34-0.65, P < 0.001) after CT-PTLB. Subgroup analysis according to study type (RCT or retrospective study), emphysema status (with or without emphysema), and ABP technique applied (clotted or non-clotted ABP) were also performed and we found ABP reduced the pneumothorax and chest tube insertion rate in all subgroups.
CONCLUSIONS: Our study indicated that the use of ABP was effective technique in reducing the pneumothorax and chest tube insertion rate after CT-PTLB.
摘要：
背景：气胸是CT引导下经皮经胸肺活检（CT-PTLB）后最常见的并发症。许多研究报道，活检针退出期间注射自体血补片（ABP）可以降低CT-PTLB后气胸和胸管插入率，但结果值得商榷。本系统评价和荟萃分析的目的是综合有关接受CT-PTLB的患者的ABP手术疗效的证据。
方法：在Pubmed，Embase和WebofScience数据库。纳入标准是评估CT-PTLB后ABP与气胸和/或胸管插入率之间关系的研究。根据研究类型进行亚组分析，还进行了肺气肿状况和应用的ABP技术。计算比值比（OR）和95％置信区间（CI）以检查风险关联。
结果：共10项研究，包括3874例患者，符合分析条件。我们的分析表明，ABP减少了气胸（发病率：20.0％vs.27.9%,OR=0.67，95％CI=0.48-0.66，P<0.001）和胸管插入率（发生率：4.0％vs.8.0%,CT-PTLB后OR=0.47,95%CI=0.34-0.65,P<0.001)。根据研究类型（RCT或回顾性研究）进行亚组分析，肺气肿状态（有或没有肺气肿），我们还进行了应用ABP技术(凝结或非凝结ABP),我们发现ABP降低了所有亚组的气胸和胸管插入率.
结论：我们的研究表明，使用ABP是降低CT-PTLB后气胸和胸管插入率的有效技术。
方法：在Pubmed，Embase和WebofScience数据库。纳入标准是评估CT-PTLB后ABP与气胸和/或胸管插入率之间关系的研究。根据研究类型进行亚组分析，还进行了肺气肿状况和应用的ABP技术。计算比值比（OR）和95％置信区间（CI）以检查风险关联。
结果：共10项研究，包括3874例患者，符合分析条件。我们的分析表明，ABP减少了气胸（发病率：20.0％vs.27.9%,OR=0.67，95％CI=0.48-0.66，P<0.001）和胸管插入率（发生率：4.0％vs.8.0%,CT-PTLB后OR=0.47,95%CI=0.34-0.65,P<0.001)。根据研究类型（RCT或回顾性研究）进行亚组分析，肺气肿状态（有或没有肺气肿），我们还进行了应用ABP技术(凝结或非凝结ABP),我们发现ABP降低了所有亚组的气胸和胸管插入率.
结论：我们的研究表明，使用ABP是降低CT-PTLB后气胸和胸管插入率的有效技术。
