胸腔镜术前CT引导下Hook-wire单钩定位单一肺结节效果观察  

Application of CT-guided Hook-wire single hook localization for thoracoscopic resection of single pulmonary nodule

作　　者：徐忆宁 郑屹峰[1] 黄小燕[1] 潘锋[1] XU Yining;ZHENG Yifeng;HUANG Xiaoyan;PAN Feng(Department of Radiology,Huzhou Central Hospital,Huzhou 313000,China)

机构地区：[1]湖州市中心医院放射科,313000

出　　处：《浙江医学》2022年第13期1424-1426,1429,共4页Zhejiang Medical Journal

基　　金：浙江省医药卫生科技计划项目(2019ZH042)。

摘　　要：目的观察胸腔镜术前CT引导下Hook-wire单钩定位单一肺结节的应用效果。方法选取2020年7月至11月湖州市中心医院收治的拟行电视胸腔镜手术(VATS)病灶切除术的单一肺结节患者116例,术前均行CT引导下Hook-wire单钩定位肺结节。观察患者VATS病灶切除术前肺结节定位结果;统计定位术后并发症发生情况,并分析并发症发生的影响因素。结果116例患者肺结节定位成功率98.3%(114/116),并发症发生率44.0%(51/116),其中气胸25.0%(29/116),出血23.3%(27/116)。多因素分析显示,进针角度是否垂直胸膜切线位是患者定位术后发生并发症的独立影响因素(OR=0.245,95%CI:0.057~0.985,P<0.05)。结论单一肺结节VATS术前CT引导下Hook-wire单钩定位是一种成功率高、定位精准且操作简便的技术,值得临床推广。穿刺时选择合适体位、尽量垂直胸膜进针有利于避免并发症的发生。Objective To evaluate the application of CT-guided Hook-wire single hook localization for thoracoscopic resection of single pulmonary nodule.Methods A total of 116 patients with a single pulmonary nodule who underwent vid-eo-assisted thoracoscopic surgery(VATS)in Huzhou Central Hospital from July to November 2020 were enrolled.The CT guided Hook-wire single hook localization of the pulmonary nodule was performed before surgery.The incidence of compli-cations after localization was documented,and the influencing factors of complications were analyzed.Results The suc-cess rate of CT-guided localization was 98.3%(114/116).The overall incidence of complications was 44.0%(51/116),the pneumothorax and hemorrhage occurred in 29 cases(25.0%)and 27 cases(23.3%),respectively.Multivariate analysis showed that the angle of needle perpendicular to the pleural tangent position was an independent protective factor for com-plications(OR=0.245,95%CI:0.057-0.985,P<0.05).Conclusion CT-guided localization with Hook-wire for single pulmo-nary nodule before the performance of VATS resection is a safe,accurate and simple technique,which is worth popularizing clinically.Choosing an appropriate body position during puncture and inserting the needle vertically into the pleura as much as possible is beneficial to reduce the complications.

关 键 词：单一肺结节 HOOK-WIRE 进针角度 并发症 LOGISTIC回归 

分 类 号：R655.3[医药卫生—外科学]