动脉流域分析定位法在胸腔镜肺楔形切除术中的应用  

Application effect of watershed analysis of the target pulmonary artery methodin thoracoscopic wedge resection of the lung

作　　者：周少 朱潇 杏福宝 王伟 宋超 李小军 唐震 张雷 ZHOU Shao;ZHU Xiao;XING Fubao;WANG Wei;SONG Chao;LI Xiaojun;TANG Zhen;ZHANG Lei(Department of Cardiothoracic Surgery,the First Affiliated Hospital of Bengbu Medical University,Bengbu,Anhui 233004,China)

机构地区：[1]蚌埠医科大学第一附属医院胸外科,安徽蚌埠233004

出　　处：《中华全科医学》2024年第1期26-29,69,共5页Chinese Journal of General Practice

基　　金：安徽省教育厅重点项目(KJ2019A0340);蚌埠医学院自然重点项目(2022byzd066);蚌埠医学院重点项目(2021byzd075)。

摘　　要：目的 探讨在胸腔镜肺楔形切除术中应用动脉流域分析定位法定位肺磨玻璃结节的可行性和安全性。方法 选取2021年11月—2023年7月蚌埠医科大学第一附属医院胸外科收治的146例胸腔镜肺楔形切除术患者为研究对象,采用随机数字表法将其分为对照组(73例,传统CT扫描弹簧圈定位)和观察组(73例,动脉流域分析定位),比较2组患者的定位效果。结果 对照组中有5例患者因结节位置特殊经安全评估后不宜行CT扫描定位,转入观察组行动脉流域分析定位。观察组的住院费用[(24 808.66±1 762.28)元]低于对照组[(25 776.73±1 723.93)元],差异有统计学意义(t=3.350,P<0.05);观察组围手术期并发症发生率为7.69%(6/78),低于对照组,差异有统计学意义[26.47%(18/68),χ^(2)=9.326,P<0.05];观察组首次切除成功率[94.87%(74/78)]高于对照组[83.82%(57/68)],差异有统计学意义(χ^(2)=4.810,P<0.05)。2组的定位时间、术中出血量、术后第1天引流量、拔管时间及病理类型比较,差异均无统计学意义(P>0.05)。结论 动脉流域分析定位法是一种有潜力的新型肺结节定位方法,可以有效保证安全手术切缘,提高结节首次切除成功率,降低患者住院费用和围手术期并发症发生率,且定位简单,尤其适用于特殊位置的肺结节,便于患者接受,值得临床推广应用。Objective To evaluate the feasibility and safety of using arterial watershed analysis in the localization of pulmonary ground glass nodules during thoracoscopic wedge resection.Methods A total of 146 patients with thoracoscopic wedge resection admitted to the Department of Thoracic Surgery,the First Affiliated Hospital of Bengbu Medical University from November 2021 to July 2023 were selected as research subjects,and the patients were divided into control group(n=73,traditional CT scan coil positioning)and observation group(n=73,identified by arterial watershed analysis)by random number table method.The localization effects of the two groups were compared.Results In the control group,5 patients were not suitable for CT scan localization due to the special location of nodules after safety evaluation by physicians,and they were transferred to the observation group and successfully localized by watershed analysis of the artery.The hospitalization cost of the observation group[(24808.66±1762.28)yuan]was lower than that of the control group[(25776.73±1723.93 yuan),t=3.350,P<0.05].The incidence of perioperative complications in the observation group was 7.69%(6/78),which was lower than 26.47%(18/68)in the control group(χ^(2)=9.326,P<0.05).The success rate of first resection in the observation group was 94.87%(74/78),which was higher than 83.82%(57/68)in the control group(χ^(2)=4.810,P<0.05).There was no significant difference in positioning time,intraoperative blood loss,drainage volume on the first day after surgery,extubation time and pathological type data between the two groups(P>0.05).Conclusion The watershed analysis of artery localization method is a potential new localization method for pulmonary nodules,which can effectively ensure the safe surgical margin,improve the success rate of nodule resection at the first time,reduce the hospitalization cost and the incidence of perioperative complications,and the localization is simple,especially suitable for pulmonary nodules in special locations.It is easily acc

关 键 词：动脉流域分析定位法 胸腔镜肺楔形切除术 肺磨玻璃结节 定位 

分 类 号：R655.3[医药卫生—外科学]