The factor analysis of the incidence of pneumothorax after CT-guided 125I radioactive seed implantation for lung cancer

Objective To analyze the impact factors of incidence of pneumothorax after CT guided puncture with radioactive 125I seed implantation in lung cancer patients.Methods 821 cases with lung cancer were treated with CT-guided percutaneous with radioactive particles implantation.198 cases of pneumothorax patients were collected.The impact factors of incidence of pneumothorax were analyzed by parallel unconditioned logistic regression.Results 24.1％ (198/821) of cases had pneumothorax after CT guided puncture.Single variate analysis showed that the incidence of pneumothorax was ralated with seven factors,such as patients with the average depth of implanted needle,whether patients with COPD(chronic obstructive pulmonary diseases),atelectasis,implantation pin number and operation time,puncture angle,and the diameter of the tumor(x2 =10.293,11.463,5.310,8.868,13.348,9.326,16.504,P ＜0.05).176 patients of intercurrent COPD with postoperative pneumothorax suffered from 65 cases.The cases of distance between the chest wall and needle less than 6 cm(205 cases),8-12 cm(378 cases)and greater than 12 cm (238 cases),the postoperative pneumothorax occurred in 29 (14.1％),98 (25.9％),71 (29.8％)cases,respectively.The number of needles were less than 5(183 cases),5-10 (408 cases),more than 10 (230 cases),the postoperative pneumothorax occurred in 31 (16.9％),92 (22.5 ％),75 (32.6％),respectively.The surgery time was less than 10 min(198 cases),10-20 min(412 cases)and more than 30 min(211 cases),the postoperative pneumothorax occurred in 27(13.6％),101 (24.5％),70(33.2％) respectively.19 cases(14.4％) with COPD (132 case) suffered from pneumothorax.The multivariate logistic regression analysis showed that the prior four factor were risk factors of pneumothorax (OR =1.676,2.147,1.827,2.368,P ＜0.05),and the last one is protective factor(OR =0.367,P ＜ 0.05).Conclusions COPD disease history,long distance between lesion and chest wall,plenty of needles surgery time can affect the incidence of pneumothorax after CT guided puncture with 125I implantation in lung cancer patients. Key words: Lung cancer;  Radioactive 125I seed;  CT;  Pneumothorax