术前CT引导下氰基丙烯酸酯联合亚甲蓝定位肺小结节的临床应用  

Preoperative CT-guided localization of small pulmonary nodules with cyanoacrylate and methylene blue

作　　者：单立梅 翟荣 吴泽宇 姚飞 彭鹏 刘亮 王剑 SHAN Li-mei;ZHAI Rong;WU Ze-yu;YAO Fei;PENG Peng;LIU Liang;WANG Jian(Department of Thoracic Surgery,The Affiliated Jiangning Hospital of Nanjing Medical University,Nanjing,Jiangsu 211000,China;不详)

机构地区：[1]南京医科大学附属江宁医院心胸外科,江苏南京211000 [2]南京医科大学附属江宁医院放射科,江苏南京211000

出　　处：《中国临床研究》2022年第4期503-506,511,共5页Chinese Journal of Clinical Research

摘　　要：目的探讨术前使用计算机断层扫描(CT)引导氰基丙烯酸酯联合亚甲蓝定位肺小结节的可行性、安全性和有效性。方法采用回顾性研究方法,选取南京市江宁医院2020年5月至2021年5月收治的162例患者(共计167个肺小结节),在电视胸腔镜手术(VATS)前,行CT引导下氰基丙烯酸酯联合亚甲蓝经皮定位,对其围手术期情况进行分析。结果162例患者的167个结节术前均定位成功,定位所需时间为(10.72±3.19)min。患者定位过程均无过敏、栓塞等严重并发症,也无移位或脱位;38例(23.46%)出现局部定位相关并发症:气胸24例,肺内出血10例,部分定位胶自气管咳出8例(其中4例为气胸合并肺内出血),无一例需临床干预;术后均未见相关迟发性并发症发生。所有病灶均在定位次日VATS下成功切除。结论术前CT引导下氰基丙烯酸酯联合亚甲蓝对肺小结节定位是一种简单可行、安全有效的方法。Objective To investigate the safety,feasibility and effectiveness of preoperative CT-guided localization for small pulmonary nodule(SPNs)with a mixture of cyanoacrylate and methylene blue.Methods A retrospective study was performed on 162 patients(with 167 SPNs)admitted to Nanjing Jiangning Hospital from May 2020 to May 2021,who received CT-guided percutaneous location of cyanoacrylate and methylene blue before video-assisted thoracoscopic surgery(VATS).Results All 167 nodules in 162 patients were successfully marked before operation,and the time required for localization was(10.72±3.19)min.There were no severe complications such as allergy,embolism,displacement or dislocation during the positioning process.Out of 38 cases(23.46%)with local localization-related complications,there were 24 cases of pneumothorax,10 cases of intrapulmonary hemorrhage and 8 cases of some glue for localization expelled from the trachea by coughing(including 4 cases of pneumothorax combined with intrapulmonary hemorrhage).No cases needed with clinical intervention.All nodules were successfully resected under VATS the next day of localization,and there were no related delayed complications after operation.Conclusion Preoperative CT-guided localization of cyanoacrylate combined with methylene blue is a simple,safe and feasible method for the patients with SPNs undergoing VATS.

关 键 词：氰基丙烯酸酯 亚甲蓝 肺小结节 术前定位 胸腔镜手术 

分 类 号：R655.3[医药卫生—外科学]