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Chest:支气管内超声引导下经支气管活检后感染并发症的危险因素

2020-03-10 xing.T MedSci原创

由此可见,病灶CT表现为空化、LDAs以及经支气管镜观察到的支气管狭窄是EBUS-GS-TBB术后感染的危险因素。在该队列中,预防性抗生素未能预防EBUS-GS-TBB感染并发症。

支气管内超声引导下通过导管鞘经支气管穿刺活检术(EBUS-GS-TBB)后的感染性并发症严重,可能会延迟或改变预定的后续治疗。近日,呼吸领域权威杂志chest上发表了一篇研究文章,该研究的目的是明确EBUS-GS-TBB术后感染的危险因素。

研究人员回顾了2013年1月至2017年12月在藤田健康大学医院连续就诊的1045例因周围性肺部病变接受EBUS-GS-TBB的患者医疗记录。研究人员评估了EBUS-GS-TBB后感染性并发症的危险因素如下:病人特征(年龄、并发症)、病灶大小、目标病变的CT特征(瘤内低密度面积(LDAs)、空洞)、支气管镜检查观察到支气管狭窄和EBUS-GS-TBB之前的实验室检查数据(白细胞计数和c反应蛋白浓度)。

47例患者发生感染并发症(肺炎24例,瘤内感染14例,肺脓肿3例,胸膜炎3例,脓胸3例),其中并发症导致癌症治疗延误13例,癌症治疗取消7例,死亡3例。多因素分析显示,EBUS-GS-TBB术后的感染并发症与瘤内LDAs (P<0.001)、经支气管镜检查发现的支气管狭窄(P<0.001)、空洞(P=0.007)密切相关。感染组共13例患者给予预防性抗生素治疗。倾向匹配分析未发现预防性抗生素治疗在预防EBUS-GS-TBB感染方面的显著益处。

由此可见,病灶CT表现为空化、LDAs以及经支气管镜观察到的支气管狭窄是EBUS-GS-TBB术后感染的危险因素。在该队列中,预防性抗生素未能预防EBUS-GS-TBB感染并发症。

原始出处:

Tomohide Souma,et al.Risk factors of infectious complications after endobronchial ultrasound-guided transbronchial biopsy.chest.2020.https://doi.org/10.1016/j.chest.2020.02.025

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    2020-04-27 丁鹏鹏
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    2021-01-06 Smile2680
  5. [GetPortalCommentsPageByObjectIdResponse(id=2051531, encodeId=f562205153171, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Wed Jul 08 05:45:55 CST 2020, time=2020-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1758217, encodeId=391c1e58217f6, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Mon Apr 27 08:45:55 CST 2020, time=2020-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1813474, encodeId=9a0a18134e446, content=<a href='/topic/show?id=0ba692e7473' target=_blank style='color:#2F92EE;'>#超声引#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92774, encryptionId=0ba692e7473, topicName=超声引)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bb182500058, createdName=yuhaisheng_ibp_32061711, createdTime=Mon Sep 07 17:45:55 CST 2020, time=2020-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1929621, encodeId=53941929621c2, content=<a href='/topic/show?id=9e604625ab' target=_blank style='color:#2F92EE;'>#Chest#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4625, encryptionId=9e604625ab, topicName=Chest)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Wed Jan 06 23:45:55 CST 2021, time=2021-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1769823, encodeId=72321e6982373, content=<a href='/topic/show?id=b3fc92e7516' target=_blank style='color:#2F92EE;'>#超声引导#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92775, encryptionId=b3fc92e7516, topicName=超声引导)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d66e38113145, createdName=guoyibin, createdTime=Sun Apr 05 03:45:55 CST 2020, time=2020-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1892224, encodeId=b965189222486, content=<a href='/topic/show?id=1b445e1232d' target=_blank style='color:#2F92EE;'>#支气管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57123, encryptionId=1b445e1232d, topicName=支气管)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f503121, createdName=zjubiostat, createdTime=Mon Nov 23 22:45:55 CST 2020, time=2020-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1278185, encodeId=969312e8185ba, content=<a href='/topic/show?id=d34e6523544' target=_blank style='color:#2F92EE;'>#活检#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65235, encryptionId=d34e6523544, topicName=活检)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Thu Mar 12 03:45:55 CST 2020, time=2020-03-12, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=2051531, encodeId=f562205153171, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Wed Jul 08 05:45:55 CST 2020, time=2020-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1758217, encodeId=391c1e58217f6, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Mon Apr 27 08:45:55 CST 2020, time=2020-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1813474, encodeId=9a0a18134e446, content=<a href='/topic/show?id=0ba692e7473' target=_blank style='color:#2F92EE;'>#超声引#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92774, encryptionId=0ba692e7473, topicName=超声引)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bb182500058, createdName=yuhaisheng_ibp_32061711, createdTime=Mon Sep 07 17:45:55 CST 2020, time=2020-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1929621, encodeId=53941929621c2, content=<a href='/topic/show?id=9e604625ab' target=_blank style='color:#2F92EE;'>#Chest#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4625, encryptionId=9e604625ab, topicName=Chest)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Wed Jan 06 23:45:55 CST 2021, time=2021-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1769823, encodeId=72321e6982373, content=<a href='/topic/show?id=b3fc92e7516' target=_blank style='color:#2F92EE;'>#超声引导#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92775, encryptionId=b3fc92e7516, topicName=超声引导)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d66e38113145, createdName=guoyibin, createdTime=Sun Apr 05 03:45:55 CST 2020, time=2020-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1892224, encodeId=b965189222486, content=<a href='/topic/show?id=1b445e1232d' target=_blank style='color:#2F92EE;'>#支气管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57123, encryptionId=1b445e1232d, topicName=支气管)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f503121, createdName=zjubiostat, createdTime=Mon Nov 23 22:45:55 CST 2020, time=2020-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1278185, encodeId=969312e8185ba, content=<a href='/topic/show?id=d34e6523544' target=_blank style='color:#2F92EE;'>#活检#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65235, encryptionId=d34e6523544, topicName=活检)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Thu Mar 12 03:45:55 CST 2020, time=2020-03-12, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=2051531, encodeId=f562205153171, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Wed Jul 08 05:45:55 CST 2020, time=2020-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1758217, encodeId=391c1e58217f6, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Mon Apr 27 08:45:55 CST 2020, time=2020-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1813474, encodeId=9a0a18134e446, content=<a href='/topic/show?id=0ba692e7473' target=_blank style='color:#2F92EE;'>#超声引#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92774, encryptionId=0ba692e7473, topicName=超声引)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bb182500058, createdName=yuhaisheng_ibp_32061711, createdTime=Mon Sep 07 17:45:55 CST 2020, time=2020-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1929621, encodeId=53941929621c2, content=<a href='/topic/show?id=9e604625ab' target=_blank style='color:#2F92EE;'>#Chest#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4625, encryptionId=9e604625ab, topicName=Chest)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Wed Jan 06 23:45:55 CST 2021, time=2021-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1769823, encodeId=72321e6982373, content=<a href='/topic/show?id=b3fc92e7516' target=_blank style='color:#2F92EE;'>#超声引导#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92775, encryptionId=b3fc92e7516, topicName=超声引导)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d66e38113145, createdName=guoyibin, createdTime=Sun Apr 05 03:45:55 CST 2020, time=2020-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1892224, encodeId=b965189222486, content=<a href='/topic/show?id=1b445e1232d' target=_blank style='color:#2F92EE;'>#支气管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57123, encryptionId=1b445e1232d, topicName=支气管)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f503121, createdName=zjubiostat, createdTime=Mon Nov 23 22:45:55 CST 2020, time=2020-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1278185, encodeId=969312e8185ba, content=<a href='/topic/show?id=d34e6523544' target=_blank style='color:#2F92EE;'>#活检#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65235, encryptionId=d34e6523544, topicName=活检)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Thu Mar 12 03:45:55 CST 2020, time=2020-03-12, status=1, ipAttribution=)]
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