术前CT引导穿刺定位辅助胸腔镜手术在肺小结节患者治疗中的临床效果观察  

Clinical observation of preoperative CT guided puncture localization assisted thoracoscopic surgery in the treatment of patients with small pulmonary nodules

作　　者：梁振 丁宁[2] LIANG Zhen;DING Ning(Department of Thoracic Surgery,Zaozhuang Municipal Hospital,Zaozhuang 277000,China)

机构地区：[1]枣庄市立医院胸外科,277000 [2]枣庄市妇幼保健院影像科,277000

出　　处：《中国实用医药》2023年第10期12-16,共5页China Practical Medicine

摘　　要：目的 探讨术前CT引导穿刺定位辅助胸腔镜手术治疗肺小结节的临床疗效。方法 154例肺小结节患者均采用胸腔镜肺楔形切除术治疗,按照随机数字表法分为试验组和对照组,每组77例。试验组给予术前CT引导穿刺定位,对照组给予术前CT常规体表定位。比较两组定位准确率、定位相关并发症发生率、楔型切除手术成功率、术后并发症发生率、手术时间、术后引流量、术后疼痛程度。结果 试验组定位准确率93.51%高于对照组的83.12%,定位相关并发症发生率5.19%高于对照组的0,差异有统计学意义(P<0.05)。试验组楔型切除手术成功率96.10%高于对照组的84.42%,术后并发症发生率2.60%低于对照组的11.69%,差异有统计学意义(P<0.05)。试验组手术时间(28.25±6.14)min短于对照组的(33.94±7.36)min,术后引流量(322.84±67.51)ml少于对照组的(350.42±64.28)ml,视觉模拟评分法(VAS)评分(3.10±0.64)分低于对照组的(3.37±0.59)分,差异有统计学意义(P<0.05)。结论 术前CT引导穿刺定位准确率高,辅助肺小结节胸腔镜手术可缩短手术时间,提高病灶楔形切除成功率,术后引流少、疼痛轻、并发症发生率低,但要警惕及预防穿刺并发出血和气胸,以更好保障患者治疗的安全性。Objective To discuss the clinical efficacy of preoperative CT guided puncture localization assisted thoracoscopic surgery in the treatment of patients with small pulmonary nodules.Methods 154 patients with small pulmonary nodules were selected and all were treated by thoracoscopic wedge excision of lung,and were divided into experimental group and control group according to random numerical table,with 77 cases in each group.The experimental group received preoperative CT guided puncture localization,and the control group received preoperative CT conventional body surface location.Both groups were compared in terms of localization accuracy,the incidence of localization-related complications,the success rate of wedge excision,the incidence of postoperative complications,the operative time,postoperative drainage,and the level of postoperative pain.Results The localization accuracy of the experimental group was 93.51%,which was higher than that of 83.12%of the control group;the incidence of localization related complications of the experimental group was 5.19%,which was higher than that of 0 of the control group;the differences were statistically significant(P<0.05).The success rate of wedge excision of 96.10%in the experimental group was higher than that of 84.42%in the control group;the incidence of postoperative complications of 2.60%in the experimental group was lower than that of 11.69%in the control group;the differences were statistically significant(P<0.05).The operative time of(28.25±6.14)min in the experimental group was shorter than that of(33.94±7.36)min in the control group;the postoperative drainage of(322.84±67.51)ml in the experimental group was shorter than that of(350.42±64.28)ml in the control group;VAS score of(3.10±0.64)points in the experimental group was lower than that of(3.37±0.59)points in the control group;the differences were statistically significant(P<0.05).Conclusion The accuracy of preoperative CT-guided puncture localization is high,assisted thoracoscopic surgery can shorten the

关 键 词：肺小结节 胸腔镜手术 CT引导穿刺定位 定位准确性 辅助治疗 

分 类 号：R655.3[医药卫生—外科学]