CT导向弹簧圈联合亚甲蓝在肺小结节胸腔镜术前定位中的应用

赵群; 张应战; 王刚; 蒋礼; 蔡超

doi:10.13898/j.cnki.issn.1000-2200.2019.12.026

CT导向弹簧圈联合亚甲蓝在肺小结节胸腔镜术前定位中的应用

Application of CT-guided spring coil combined with methylene blue in the preoperative localization of small pulmonary nodules prior to thoracoscopy

摘要

摘要:
目的探讨CT导向弹簧圈联合亚甲蓝在肺小结节胸腔镜手术中术前定位的应用。
方法选取肺小结节胸腔镜手术病人40例，抽签随机分配至弹簧圈联合亚甲蓝组（A组）和单纯弹簧圈定位组（B组），A组23例，B组17例。对比分析2组术前定位成功率、定位并发症发生率、术中探查时间、手术时间、中转开胸率、术中冷冻病理阳性率和住院时间。
结果40例定位成功率和楔形切除率均为100%；2组定位时间、气胸和出血发生率以及手术时间差异均无统计学意义（P>0.05）；切除位点探查时间A组为（2.02±0.68）min，显著低于B组的（5.84±1.06）min（P < 0.01）；B组中4例扩大切除，均为深部结节，A组为0例，2组切除率差异无统计学意义（P>0.05）。
结论CT引导下弹簧圈联合亚甲蓝定位用于肺内小结节术前定位可以迅速帮助手术医生找到肺内小结节，尤其对于深部结节，切除率高，是一种简单、直观、安全、有效、精确的方法，具有较高的临床推广价值。

Abstract:
ObjectiveTo explore the application of CT-guided spring coil combined with methylene blue in the preoperative localization of small pulmonary nodules prior to thoracoscopy.
MethodsForty patients with small pulmonary nodules scheduled for thoracoscopy were randomly divided into spring coil combined methylene blue group (group A, n=23) and simple spring coil localization group (group B, n=17).The success rate of preoperative localization, incidence rate of complications, intraoperative exploration time, operation time, rate of conversion to thoracotomy, positive rate of intraoperative frozen pathology and average hospitalization time in two groups were analyzed.
ResultsIn 40 patients, the success rate of localization and wedge resection rate were 100%.There was no significant difference in the localization time, pneumothorax, bleeding rate and operation time between two groups(P>0.05).The exploration time of resection sites in group A(2.02±0.68) min was significantly lower than that in group B(5.84±1.06) min(P < 0.01).There were 4 cases of deep nodules with enlarged resection in group A, no case was found in group B, and the difference of resection rate between two groups was not statistically significant(P>0.05).
ConclusionsPreoperative localization of small pulmonary nodules by CT-guided spring coil combined with methylene blue can help surgeons to find small pulmonary nodules quickly, especially for deep nodules.It is a simple, intuitive, safe, effective and accurate method with high clinical value.

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