胸腔镜术前Hook-wire穿刺定位肺部单纯性磨玻璃样结节  

Application of Hook-wire in the puncture localization of pulmonary simple ground-glass like nodule before thoracoscopic surgery

作　　者：叶红雨[1] 黄伟钊[1] 吴颖猛[1] 梁毅[1] 郑俊猛[1] 姜海明[1] 

机构地区：[1]中山市人民医院(中山大学附属中山医院)心胸外科,广东中山528403

出　　处：《岭南现代临床外科》2012年第4期359-361,共3页Lingnan Modern Clinics in Surgery

基　　金：2011中山市卫生局科研立项(J2011045)

摘　　要：目的探讨胸腔镜术前采用hook-wire穿刺定位肺部单纯性磨玻璃样结节的应用价值。方法 39例患者,共41个直径小于2cm的肺部pGGO病灶,行全胸腔镜下病灶切除术,术前均在DSAInnovaCT引导下采用hook-wire对病灶穿刺定位,对临床数据进行回顾性分析,对手指触诊阳性率与病灶临床因素进行相关性分析,比较手指触诊与hook-wire定位的成功率,总结hook-wire定位定位的并发症等。结果术中触诊12个病灶(29.3%)可触及并明确定位;3个病灶(7.3%)术中发现穿刺针移位;病灶的大小、深浅、病理类型、所在部位以及穿刺定位过程的时间长短,与触诊的阳性率无显著关系,39个(95.1%)病灶可通过hook-wire准确定位,与触诊比较准确性有显著差异(P<0.01);常见并发症为无症状气胸5例(12.8%),血胸2例(5.2%),严重胸痛1例(2.6%)。结论对于小于直径2cm的肺部pGGO,胸腔镜手术有必要常规进行病灶的定位,其中采用Hook-wire对病灶进行穿刺定位是一项有效、安全的技术。Objective To retrospectively analyze the clinical significance of preoperative Hook wire localization of pulmonary pure ground-glass opacity （pGGO） for video-assisted thoracoscopic surgery. Methods Thirty-nine patients with 41 pulmonary pGGO （less than 2cm in diameter） underwent preoperative hookwire localization guided by DSA Innova CT prior to video-assisted thoracoscopic lesion resection. Relationship between positive rate of finger palpation and clinical pathological factors was analyzed retrospectively. Success rate in localization was compared between finger palpation and hook wire localization. Complications resulting from hook wire localization were also summarized. Result Twelve lesions （29.3%） were successfully identified by palpation. Hook wire dislodgment occurred in 3 （7.3%） lesions. Correlation was not found between positive rate of finger palpation and the size, depth, pathological examination, location of the lesion and procedure time of hook wire localization. 39 （95.1%） lesions were successfully identified by hook wire and the success rate was higher than finger palpation significantly （P〈0.01）. 5 cases （12.8%） had asymptomatic minimal pneumothoraces, 2 （5.2%） had minimal hemothorax, and one （2.6%） had serious chest pain. Conclusions Preoperative localization of diameter less than 2 cm pulmonary pGGO is necessary for video-assisted thoracoscopic surgery and hook wire localization is one of the effective and safe techniques.

关 键 词：HOOK-WIRE 磨玻璃样结节 定位 胸腔镜手术 

分 类 号：R734.2[医药卫生—肿瘤]