吲哚菁绿联合医用胶在胸腔镜下肺小结节手术定位中的应用  

Application of Indocyanine Green Combined With Medical Glue in the Localization of Small Pulmonary Nodules in Video-assisted Thoracoscopic Surgery

作　　者：钱坤[1] 张毅[1] 魏博华 刘幸生 刘禹良 张颖贞 Qian Kun;Zhang Yi;Wei Bohua(Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China)

机构地区：[1]首都医科大学宣武医院胸外科,北京100053

出　　处：《中国微创外科杂志》2020年第9期818-821,共4页Chinese Journal of Minimally Invasive Surgery

基　　金：北京市医院管理局临床技术创新项目(XMLX201702)。

摘　　要：目的探讨吲哚菁绿(indocyanine green,ICG)联合医用胶在胸腔镜下肺小结节手术定位中的应用价值。方法回顾性分析2018年2月~2019年2月68例术前定位并接受胸腔镜下肺小结节(直径0.7~2 cm)切除术的病例资料,2个手术组分别采用联合注射ICG加医用胶(A组,30例)或单纯注射医用胶定位(B组,38例),2组性别、年龄、病灶直径、结节距胸膜距离和结节密度无统计学差异,比较2组定位成功率、定位时间、结节切除时间、并发症发生率和病理结果。结果A组定位成功率[100%(30/30)]高于B组[84.2%(32/38)](Fisher精确检验,P=0.031),胸腔镜肺结节切除时间A组[(19.5±3.8)min]短于B组[(44.3±15.2)min](t=-9.655,P=0.000),2组病灶定位时间[(19.7±4.3)min vs.(18.7±2.8)min],气胸发生率[6.7%(2/30)vs.10.5%(4/38)],定位后胸痛视觉模拟评分(Visual Analogue Score,VAS)[(1.4±1.2)分vs.(1.3±1.3)分],术后病理恶性占比[73.3%(22/30)vs.63.2%(24/38)]无统计学差异(P>0.05),无严重并发症发生。结论与医用胶定位相比,ICG联合医用胶在胸腔镜下肺小结节手术定位中能提高定位成功率,缩短手术时间,安全性良好。Objective To assess the clinical value of indocyanine green(ICG)combined with medical glue in the localization of small pulmonary nodules in video-assisted thoracoscopic surgery(VATS).Methods We retrospectively analyzed clinical data of 68 patients with small nodules(diameter,0.7-2 cm)who received preoperative localization and underwent VATS wedge resection from February 2018 to February 2019.The patients were divided into two groups receiving different localization methods:ICG combined with medical glue(group A)in 30 cases and medical glue only(group B)in 38 cases.There was no significant difference in gender,age,nodule diameter,distance from the visceral pleura and nodule density between the two groups.The success rate of localization,time of localization and nodule resection,incidence of complications,and pathological findings of the two groups were compared.Results The success rate of localization in the group A[100%(30/30)]was significantly higher than that in the group B[84.2%(32/38)](Fisher’s exact test,P=0.031).The time of nodule resection in the group A[(19.5±3.8)min]was significantly shorter than that in the group B[(44.3±15.2)min](t=-9.655,P=0.000).There were no statistical differences(P>0.05)in time of localization[(19.7±4.3)min vs.(18.7±2.8)min],incidence of pneumothorax[6.7%(2/30)vs.10.5%(4/38)],Visual Analogue Score(VAS)of chest pain after localization[(1.4±1.2)points vs.(1.3±1.3)points]and the ratio of malignant lesions[73.3%(22/30)vs.63.2%(24/38)].No serious complications occurred in all the patients.Conclusion ICG combined with medical glue is a safe method of localization which can improve the success rate of localization and shorten the operation time for small pulmonary nodules in video-assisted thoracoscopic surgery.

关 键 词：肺结节 定位 胸腔镜 楔形切除 

分 类 号：R73[医药卫生—肿瘤]