单发肺结节术前CT引导下医用胶辅助定位的学习曲线  

Learning curve of CT-guided localization with medical glue for single pulmonary nodule before video-assisted thoracic surgery

作　　者：谭晓刚[1] 张秋航[2] 李岩[3] 田笑如 刘宝东[1] TAN Xiaogang;ZHANG Qiuhang;LI Yan;TIAN Xiaoru;LIU Baodong(Department of Thoracic Surgery,Xuanwu Hospital,Capital Medical University,Beijing,100053,P.R.China;Department of Radiotherapy,Xuanwu Hospital,Capital Medical University,Beijing,100053,P.R.China;Department of Radiology,Xuanwu Hospital,Capital Medical University,Beijing,100053,P.R.China)

机构地区：[1]首都医科大学宣武医院胸外科,北京100053 [2]首都医科大学宣武医院放射治疗科,北京100053 [3]首都医科大学宣武医院放射科,北京100053

出　　处：《中国胸心血管外科临床杂志》2023年第9期1273-1279,共7页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：首都医科大学临床专科学院(系)开放课题(RG00667)。

摘　　要：目的探讨单发肺结节手术前CT引导下医用胶辅助定位的学习曲线。方法回顾性分析2018年7月—2021年3月首都医科大学宣武医院肺结节胸腔镜手术(video-assisted thoracic surgery,VATS)前行CT引导下医用胶辅助定位患者的临床资料。按照时间顺序将患者分为3组:A组(2018年7月—2019年8月)、B组(2019年9月—2020年6月)和C组(2020年7月—2021年3月)。比较3组的定位时间、并发症发生率、手术切除率等。结果共纳入77例患者,其中男24例、女53例,平均年龄(57.4±10.1)岁。A组25例,B组21例,C组31例,共定位77个肺结节。3组患者基线资料差异无统计学意义(P>0.05)。C组定位操作时间[(10.6±2.0)min]明显短于A组[(15.4±4.4)min]和B组[(12.9±4.3)min],差异有统计学意义(P<0.01)。C组并发症发生率低于A组和B组(25.8%vs.52.0%vs.47.6%,P=0.04)。3组定位成功率差异无统计学意义(P=0.12)。结论VATS术前行CT引导下医用胶辅助定位存在学习曲线的问题,经过46例的经验积累,可缩短定位操作时间、降低并发症发生率。Objective To evaluate the learning curve of CT-guided medical glue localization for pulmonary nodule before video-assisted thoracic surgery(VATS).Methods The clinical data of the patients with pulmonary nodules who underwent CT-guided medical glue localization before VATS in our hospital from July 2018 to March 2021were retrospectively analyzed.The patients were divided into 3 groups:a group A(from July 2018 to August 2019),a group B(from September 2019 to June 2020)and a group C(from July 2020 to March 2021).The localization time,morbidity,complete resection rate and other indexes were compared among the three groups.Results A total of 77patients were enrolled,including 24 males and 53 females aged 57.4±10.1 years.There were 25 patients in the group A,21patients in the group B,and 31 patients in the group C.77 pulmonary nodules were localized.There was no significant difference among the groups in the basic data(P0.05).The localization time in the group C was 10.6±2.0 min,which was statistically shorter than that in the group A(15.4±4.4 min)and group B(12.9±4.3 min)(P0.01).The incidence of complications in the group C was lower than that in the group A and group B(25.8%vs.52.0%vs.47.6%,P=0.04).The success rate of localization of the three groups was not statistically different(P=0.12).Conclusion There is a learning curve in CT-guided medical glue localization for single pulmonary nodule before VATS.After the first 46 cases,the operation time can be shortened,and the incidence of complications can be decreased.

关 键 词：肺结节 医用胶 定位 胸腔镜手术 学习曲线 

分 类 号：R563[医药卫生—呼吸系统]