双极激光定位导航仪在肺癌CT引导经皮肺穿刺活检中的应用  

Application of bipolar laser positioning navigator in CT-guided percutaneous transthoracic needle biopsy for lung cancer

作　　者：杨纯杰[1] 吴月敏[1] 胡颜江[1] 董建春[1] 李栋[2] 夏阳 YANG Chunjie;WU Yuemin;HU Yanjiang;DONG Jianchun;LI Dong;XIA Yang(Department of Thoracic Surgery, Liyang People's Hospital, Changzhou 213300, China)

机构地区：[1]溧阳市人民医院心胸外科,江苏常州213300 [2]溧阳市人民医院放射科,213300 [3]南京医科大学第一附属医院胸外科,210029

出　　处：《临床肿瘤学杂志》2020年第12期1116-1120,共5页Chinese Clinical Oncology

基　　金：国家自然科学基金资助项目(81702262)。

摘　　要：目的探讨自制双极激光定位导航仪在肺癌CT引导经皮肺穿刺活检(CT-PTNB)中的应用效果。方法选取本院2018年1月至2020年1月行CT-PTNB确诊的100例肺癌患者,其中50例在CT-PTNB过程中使用自制双极激光定位导航仪精准定位并实时引导穿刺的患者为观察组,余50例按常规方法进行CT-PTNB的患者为对照组,比较两组穿刺过程中的一次性置入预定位成功率、调针次数、CT扫描次数、穿刺操作时间、并发症发生率和穿刺时及穿刺后10 min的舒适度评分。结果与对照组相比,观察组一次性置入预定位成功率高(94.0%vs.58.0%)、穿刺过程中调针次数少[(1.06±0.24)次vs.(1.70±0.97)次]、CT扫描次数少[(3.06±0.24)次vs.(3.74±0.98)次]、穿刺操作时间短[(18.86±1.52)min vs.(23.56±2.95)min]、并发症中气胸发生率(10.0%vs.28.0%)和出血发生率(8.0%vs.26.0%)低、穿刺时舒适度评分[(92.18±4.57)分vs.(80.04±4.94)分]及穿刺后10 min的舒适度评分[(96.32±4.15)分vs.(86.86±5.29)分]高,差异均有统计学意义(P<0.05)。两组并发症中咯血和疼痛发生率的差异无统计学意义(P>0.05)。观察组中肺肿瘤直径<20 mm的并发症发生率低(28.5%vs.72.7%,P=0.010),穿刺深度≥8 cm的并发症发生率低(23.3%vs.72.7%,P<0.001),而肿瘤直径≥20 mm以及穿刺深度<8 cm的两组差异均无统计学意义(P>0.05)。结论自制双极激光定位导航仪在肺癌CT-PTNB中的应用效果良好,易于掌握且并发症少,患者舒适度高,具有一定的临床应用价值。Objective To explore the clinical application effect of self-made bipolar laser positioning navigator in CT-guided percutaneous transthoracic needle biopsy(CT-PTNB)for lung cancer.Methods One hundred patients with lung cancer diagnosed by CT-PTNB in our hospital from January 2018 to January 2020 were enrolled.The observation group consisted of 50 patients who underwent CT-PTNB by using self-made bipolar laser positioning navigator to precisely locate and real-time guide the puncture.The remaining 50 patients who underwent CT-PTNB according to the conventional method were selected as the control group.The success rate of one-time pre-positioning,needle adjusting times,CT scanning times,duration of puncture operation,incidence of complications and comfort scores during the puncture and 10 minutes after the puncture were compared between both groups.Results Compared with control group,there were higher success rate of pre-positioning(94.0%vs.58.0%),less needle adjusting times[(1.06±0.24)vs.(1.70±0.97)],less CT scanning times[(1.06±0.24)vs.(1.70±0.97)],shorter duration of puncture operation[(18.86±1.52)min vs.(23.56±2.95)min],lower incidences of pneumothorax(10.0%vs.28.0%)and bleeding(8.0%vs.26.0%)in the complications as well as higher scores of comfort during puncture[(92.18±4.57)vs.(80.04±4.94)]and 10 min after puncture[(96.32±4.15)vs.(86.86±5.29)]in observation group(P<0.05).There was no significant difference in the incidence of hemoptysis and pain between both groups(P>0.05).In observation group,there were lower incidences of complications in lung tumor diameter<20 mm(28.5%vs.72.7%)and puncture depth≥8 cm(23.3%vs.72.7%)with significant difference(P<0.05).There was no significant difference between both groups in tumor diameter≥20 mm and puncture depth<8 cm(P>0.05).Conclusion The application of self-made bipolar laser-positioning navigator in CT-PTNB for lung cancer has good effect,few complications and low learning curve,which is worthy of clinical application.

关 键 词：肺癌 激光定位 导航 CT引导经皮肺穿刺活检 

分 类 号：R734.2[医药卫生—肿瘤]