CT引导精准定位对胸腔镜切除肺小结节的临床价值  

The value of CT-guided pre-operative localization for small pulmonary nodules

作　　者：姚明荣[1] 耿坚[1] 徐建俊[1] 詹松华[1] YAO Mingrong;GENG Jian;XU Jianjun;ZHAN Songhua(Department of Radiology,Shanghai Shuguang Hospital Affiliated With Shanghai University of Traditional Chinese Medicine,Shanghai 201203,P.R.China)

机构地区：[1]上海中医药大学附属曙光医院放射科,上海201203

出　　处：《医学影像学杂志》2021年第7期1151-1154,共4页Journal of Medical Imaging

摘　　要：目的探讨术前CT引导Hook-wire穿刺定位对胸腔镜切除肺小结节的临床价值。方法回顾分析因肺小结节行胸腔镜手术患者临床资料,评价CT引导Hook-wire穿刺定位技术成功率,并与同期未定位直接手术者比较两组手术时间、术后住院时间等。结果共212例纳入分析,穿刺定位组129例,未穿刺组83例;其中126例穿刺定位成功,成功率97.67%。定位组中转开胸率4.76%,肺楔形切除和肺叶切除时间分别为(20.53±2.50)min和(89.01±10.73)min,术后平均住院时间(4.03±1.57)天,均明显低于未定位组,差异具有统计学意义(P均<0.05)。结论CT引导Hook-wire穿刺定位,成功率高,有效降低中转开胸率、缩短手术时间及术后住院时间。Objective The aim of the study was to report the utility and the results of preoperative CT-guided hook wire localization for pulmonary nodules before thoracoscopy.Methods All patients during the period from July 2017 to December 2019 to receive video-assisted thoracic surgery(VATS)for small pulmonary nodules were reviewed.The success rate and safety of CT-guided hook wire were statistically analyzed.The conversion thoracotomy rate,duration of operation and postoperative hospital stay were evaluated.Results A total of 212 patients underwent VATS.Preoperative CT-guided hook wire localization was employed in 129 patients with a successful rate of 97.67%,while other 83 patients did not receive puncture.Conversion thoracotomy was necessary in 6 patients out of 126(4.76%).The average operative time of wedge resection and lobe resection was(20.53±2.50)min and(89.01±10.73)min.The mean postoperative hospital stay was(4.03±1.57)d,which were strikingly lower than those in anther group,the differences between the two groups were statistically significant(P<0.05).Conclusion CT-guided hook wire localization for small pulmonary nodules is safe and effective.It can decrease the conversion thoracotomy rate,operative time and hospital stay.

关 键 词：肺小结节 体层摄影术 X线计算机 钩线 胸腔镜 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]