CT引导下经皮穿刺Hook-wire定位肺磨玻璃结节的安全性及有效性研究  

Study on the safety and efficiency of CT guided percutaneous Hook-wire localization of pulmonary ground-glass opacity

作　　者：张晓华 周冰 李斌 徐鸿飞 李晶 ZHANG Xiaohua;ZHOU Bing;LI Bin;XU Hongfei;LI Jing(Department of Radiology,Jiaxing Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medicine University,Jiaxing,Zhejiang Province 314000,China;Department of Thoracic Surgery,Jiaxing Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medicine University,Jiaxing,Zhejiang Province 314000,China)

机构地区：[1]浙江中医药大学附属嘉兴中医院放射科,浙江嘉兴314000 [2]浙江中医药大学附属嘉兴中医院胸外科,浙江嘉兴314000

出　　处：《实用放射学杂志》2022年第3期475-479,共5页Journal of Practical Radiology

基　　金：浙江省医药卫生科技计划面上项目(2019KY703);嘉兴市科技局基金项目(2018AD32147).

摘　　要：目的探讨电视辅助胸腔镜手术(VATS)前使用Hook-wire定位肺磨玻璃结节(GGO)的安全性及有效性.方法回顾性分析60例患者的临床资料及Hook-wire定位、VATS相关数据,采用决策树、单因素及多因素Logistic回归分析寻找显著影响因素及相关因素.结果Hook-wire定位成功率98.3%(59/60);穿刺角度垂直47例、非垂直13例;发生并发症气胸11.7%(7/60)、穿刺道出血16.7%(10/60).VATS术中发生钩丝脱落2例,滑出5例.并发症的单因素分析提示穿刺角度、病灶长径以及Hook-wire术耗费时间是并发症产生的显著影响因素(P<0.05),Hook-wire术耗费时间与穿刺角度2个变量之间有明显多重共线性.决策树提示当Hook-wire术耗费时间>16 min时,女性和穿刺角度非垂直是并发症产生的2项显著影响因素(P<0.05).结论CT引导下Hook-wire定位技术安全、有效,医生操作时间越短、垂直进针情况下效果更佳.Objective To assess the safety and efficiency of Hook-wire localization of pulmonary ground-glass opacity(GGO)before video-assisted thoracoscopic surgery(VATS).Methods The clinical,Hook-wire localization and VATS data of 60 patients were analyzed retrospectively.Decision tree,univariate and multivariateLogisticregression analysis were used to find out the significant and the related factors.Results The success rates of Hook-wire localization was 98.3%(59/60);the puncture angle were vertical in 47 cases and non vertical in 13 cases;the complications of pneumothorax was 11.7%(7/60)and puncture tract bleeding was 16.7%(10/60).Hook-wire was dislodged in 2 cases and slipped out in 5 cases during the VATS opreation.The single factor analysis of complications suggested that puncture angle,lesion length and Hook-wire operation time were the significant influencing factors(P<0.05).There was a significant multicollinearity between Hook-wire operation time and puncture angle.The decision tree suggested that female and non vertical puncture angle were the two significant influencing factors to complications(P<0.05)when the Hook-wire operation time was more than 16 minutes.Conclusion CT guided Hook-wire localization is proved to be safe and efficient,the vertical puncture angle and shorter localization time is better.

关 键 词：Hook-wire定位 肺磨玻璃结节 电视辅助胸腔镜手术 并发症 

分 类 号：R815[医药卫生—放射医学] R563[医药卫生—临床医学] R814.42