Abstract: Objective To explore the risk factors for pain after puncturing localization using Hookwire needles for preoperative pulmonary nodules resections, providing theoretical evidences for reducing post-localization complications in patients.Methods For cross-sectional analysis,141 patients undergoing preoperative CT-guided localization using Hookwire needles for preoperative single pulmonary nodule resections in Nanjing Chest Hospital from February 2024 to May 2024.The pain levels of the patients after localization were recorded according to the numerical rating scales(NRS).Comparions the pain levels between patients' genders,ages,BMI,sides,number of intercostals at the puncture point,depths of puncture needle penetration through the chest wall,depths of puncture needle penetration in the lungs,whether the needles were inserted tightly against the ribs,and whether the needle were inserted tightly against the scapula.The influencing factors causing pain were explored by univariate analysis as well as ordered Logistic analysis.Results All 141 patients were successfully localized without serious complications,and the results of univariate analysis showed that BMI,depth of penetration within the thoracic wall of the puncture needle,whether or not the needle was inserted tightly against the ribs,and whether or not it was inserted tightly against the scapula were correlated with the post-positioning pain,and the differences were statistically significant from each other(P<0.1).Ordered Logistic regression analysis showed that the depth of penetration within the chest wall of the puncture needle (OR=1.484,95%CI=0.033~0.758,P＜0.05),and whether or not the needle was inserted tightly against the rib cage (OR=9.440,95%CI= 1.434~3.056,P＜0.05) and tight scapular entry (OR=9.994,95%CI=0.957~3.646,P＜0.05) were risk factors for pain after positioning.Conclusion The deepth of localization needle penetrating in the chest wall and puncturing close to the edge of scapula and ribs are the risk factors for pain after puncturing localization using a Hookwire needle for preoperative pulmonary nodules resection.

Key words: pulmonary nodule, preoperative localization, hookwire, pain, puncture