定位丝与Hook-wire在肺小结节胸腔镜术前定位中的应用比较  

Comparison between pulmonary nodule localization wire and Hook-wire in pre-thoracoscopy localization of small pulmonary nodules

作　　者：丁勇生[1] 杨彦松 程春[2] 冯峰[1] 王汉杰[1] 周存凉[1] DING Yongsheng;YANG Yansong;CHENG Chun;FENG Feng;WANG Hanjie;ZHOU Cunliang(Department of Radiology,Affiliated Tumor Hospital of Nantong University,Nantong 226361,Jiangsu Province,China;Department of Thoracic Surgery,Affiliated Tumor Hospital of Nantong University,Nantong 226361,Jiangsu Province,China)

机构地区：[1]南通市肿瘤医院影像科,江苏南通226361 [2]南通市肿瘤医院胸外科,江苏南通226361

出　　处：《肿瘤影像学》2023年第3期262-268,共7页Oncoradiology

基　　金：南通市卫生和计划生育委员会科研课题专项面上项目(MA2020007);南通市科技局项目(JCZ19064);南通大学临床研究专项青年项目(2019LQ014)。

摘　　要：目的:比较定位丝与Hook-wire两种定位技术在肺小结节患者胸腔镜术前定位中的有效性和安全性。方法:回顾并分析119例胸腔镜术前计算机体层成像(computed tomography,CT)引导下经皮穿刺定位的肺小结节患者的临床资料,根据不同定位方法分为定位丝组(50例)和Hook-wire组(69例),比较两组间的结节位置、结节直径、结节至胸膜的距离、定位时间、定位成功率及并发症发生率的差异,对定位后并发症的相关因素进行logistic回归分析。结果:两组间的结节位置、结节直径、结节至胸膜的距离差异无统计学意义。定位丝组与Hook-wire组定位时间相近[16(14,19)min vs 16(14,18.5)min,t=-0.416,P=0.677]。定位丝组与Hook-wire组定位成功率相近(98.0%vs 94.2%,χ^(2)=1.038,P=0.397)。定位丝组总体并发症发生率低于Hook-wire组(16.0%vs 47.8%,χ^(2)=13.003,P<0.001),亚组分析中定位丝组的气胸(12.0%vs 27.5%,χ^(2)=4.217,P=0.044)、肺出血(4.0%vs 18.8%,χ^(2)=5.796,P=0.016)、局部疼痛(0.0%vs 8.7%,χ^(2)=4.579,P<0.001)的发生率均低于Hook-wire组。Logistic回归分析结果显示,不同的定位方法是本研究中肺小结节患者胸腔镜术前定位后是否有并发症的独立危险因素(OR=0.208,95%CI 0.085~0.507,P<0.001)。结论:定位丝法定位时间、定位成功率与Hook-wire法相近,但定位丝法较Hook-wire法并发症少,值得推广。Objective:To compare the effectiveness and safety of preoperative lung localization by pulmonary nodule localization wire and Hook-wire.Methods:A retrospective analysis of the clinical data of 119 patients with preoperative pulmonary nodules located by computed tomography(CT)-guided percutaneous puncture was performed.According to the use of different localization method,they were divided into localization wire group(50 cases)and Hook-wire group(69 cases).The location of lesion,nodule size,distance between nodule and pleura,localization time,localization success rate,and incidence of complications were compared between the two groups.Related risk factors of complications were analyzed by logistic regression.Results:There was no significant difference between the two groups in nodule position,nodule diameter and the distance between the pulmonary nodule.The localization time was similar in the two groups[16(14,19)min vs 16(14,18.5)min,t=-0.416,P=0.677].The localization success rate was similar in the two groups(98.0%vs 94.2%,χ^(2)=1.038,P=0.397).The overall complications in the localization wire group were significantly lower than those in the Hook-wire group(16.0%and 47.8%,χ^(2)=13.003,P<0.001),The pneumothorax(12.0%vs 27.5%,χ^(2)=4.217,P=0.004),pulmonary hemorrhage(4.0%vs 18.8%,χ^(2)=5.796,P=0.016),local pain(0.0%vs 8.7%,χ^(2)=4.579,P<0.001)in the localization wire group were lower than the Hook-wire group in the subgroup analysis.Through the analysis of related risk factors,different localization methods were independent risk factors(OR=0.208,95%CI 0.085-0.507,P<0.001).Conclusion:The localization time and localization success rate are similar,but the localization wire group has fewer complications than the Hook-wire method,and is worthy of promotion.

关 键 词：肺结节 定位丝 HOOK-WIRE 计算机体层成像 

分 类 号：R734.2[医药卫生—肿瘤] R445.3[医药卫生—临床医学]