胸腔镜术前CT引导下双弹簧圈标记定位孤立性肺结节  

CT-guided double-coil precision markers positioning solitary pulmonary nodule before thoracoscopy surgery

作　　者：陈志明[1] 吕梁[1] 彭俊[2] 卜梁[2] 杨维新[1] 宋巍[1] 

机构地区：[1]云南省第一人民医院昆明理工大学附属医院放射科,云南昆明650032 [2]云南省第一人民医院昆明理工大学附属医院胸外科,云南昆明650032

出　　处：《中国介入影像与治疗学》2016年第7期402-405,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨术前CT引导下双弹簧圈精准标记定位在胸腔镜下切除孤立性肺结节(SPN)中的临床应用。方法对我院经胸部CT发现的45例SPN患者,术前采用CT引导下双弹簧圈精准标记定位,然后于当日或次日行胸腔镜楔形切除肺内病灶。记录弹簧圈定位时间,术中、术后并发症,观察弹簧圈在术中的引导作用。结果 CT引导下双弹簧圈可精准标记、定位肺内微小结节,成功率100%,定位操作平均时间为(18.0±5.3)min。定位后无气胸、咯血发生,沿穿刺针道及弹簧圈周围少量渗血8例(8/45,17.78%);未发生弹簧圈移位、脱落。患者均接受胸腔镜手术治疗。胸腔镜进入胸腔后均能看到标记弹簧圈并可迅速找到病灶,获得病理结果。结论采用双微弹簧圈进行SPN胸腔镜手术前精准标记定位,具有安全、准确、方便、易于操作的优点,值得临床推广应用。Objective To investigate the clinical value of CT-guided precision double-coil markers positioning before thoracoscopic resection of solitary pulmonary nodule （SPN）. Methods There were 45 SPN cases found by chest CT found, who were underwent preoperative CT-guided double-coil precision marking, and then on the same day or the next day underwent video-assisted thoracoscopy wedge resection of pulmonary lesions. The coil positioning time and postoperative complications were recorded, and the coil guiding role in surgery were observed. Results CT-guided precision double-coil could be accurately marking and positioning SPN, the success rate was 100%, the average time of positioning operation was （18.0±5.3）min, no pneumothorax and hemoptysis occurred, and a small amount of bleeding along the needle tract and around coil were found in 8 cases （8/45, 17.78%）. Coil shift or shedding was not found. All patients underwent thoracoscopic surgery. During thoracoscope surgery, the marking coil could be seen and the lesions under the guidance of the positioning coils could be found, and the pathology results also could be obtained. Conclusion Double-coil can marke and precisely position the SPN before thoracic surgery, which is safe, accurate, convenient and easy to operate, and worthy of clinical application.

关 键 词：孤立性肺结节 放射学 介入性 体层摄影术 X线计算机 弹簧圈 胸腔镜 

分 类 号：R655.3[医药卫生—外科学] R815[医药卫生—临床医学]