吲哚菁绿荧光法在胸腔镜肺减容手术的应用  

Application of indocyanine green fluorescence method in thoracoscopic pulmonary volume reduction surgery

作　　者：唐兴[1] 张聪 TANG Xing;ZHANG Cong(Department of Thoracic Surgery,First Affiliated Hospital,Soochow University,Suzhou 215006,CHINA)

机构地区：[1]苏州大学附属第一医院胸外科,江苏215006 [2]新疆伊犁哈萨克自治州友谊医院胸心外科

出　　处：《江苏医药》2021年第6期604-607,共4页Jiangsu Medical Journal

摘　　要：目的探讨吲哚菁绿荧光法在胸腔镜肺减容手术中病变范围界定的可行性。方法行胸腔镜肺减容手术患者50例,术中注射吲哚菁绿,确定肺气肿组织或巨大肺大泡位置及范围,比较术前及术后3个月PaO_(2)、PaCO_(2)、第1秒用力呼气量(FEV1)、每分钟最大通气量(MVV)和残气量(RV)。结果 50例患者均顺利完成手术。5例患者术后有不同程度的肺组织漏气,通过胸管注入50%葡萄糖促进粘连或者胸管连接负压吸引器促进余肺复张等治疗后,均在1周内愈合出院。围手术期无胸腔活动性出血、肺部感染、心律失常、急性哮喘发作等并发症发生。术后随访3个月,PaO_(2)、PaCO_(2)、FEV1、FEV1/预计值、MVV/预计值和RV均较术前改善(P<0.05)。结论在胸腔镜肺减容术中应用吲哚菁绿荧光法有助于明确病变边界,从而更加准确界定手术的靶区,具有一定临床应用价值。Objective To investigate the feasibility of indocyanine green fluorescence method in confirming the scope of the lesions in thoracoscopic pulmonary volume reduction surgery.MethodsThe indocyanine green injection was performed intraoperatively to show the location and scope of the emphysema tissues or huge lung bullae in 50 patients undergoing thoracoscopic pulmonary volume reduction surgery.The PaO_(2),PaCO_(2),forced expiratory volume in the first second(FEV1),maximum ventilation per minute(MVV)and residual volume(RV)were compared before and 3 months after operation.Results The operation was completed successfully in all the patients.The lung leakage in different degrees was seen in 5 patients after operation,who were treated by injecting 50%glucose into the chest tube to promote adhesion,or by connecting the chest tube to a negative pressure suction device to promote the residual lung reconstruction,and discharged within one week.No active bleeding,pulmonary infection,arrhythmia and acute asthma attack happened during perioperative period.The PaO_(2),PaCO_(2),FEV1,the ratio of FEV1 to predicted value,the ratio of MVV to predicted value and RV were improved in 3 months after operation than those before(P<0.05).ConclusionThe indocyanine green fluorescence method applied to thoracoscopic pulmonary volume reduction surgery is helpful to clarify the boundary of the lesions,which has certain clinical application value so as to more accurately define the target area.

关 键 词：吲哚菁绿 胸腔镜手术 肺减容手术 

分 类 号：R655[医药卫生—外科学]