电磁导航支气管镜辅助下老年多发肺结节患者定位的临床应用  

Clinical application of electromagnetic navigation bronchoscopy-guided localization in elderly patients with multiple pulmonary nodules

作　　者：姚源山 项鲁婕 陈春基 张辉标 唐东方 高文 Yao Yuanshan;Xiang Lujie;Chen Chunji;Zhang Huibiao;Tang Dongfang;Gao Wen(Department of Thoracic Surgery,Shanghai Key Laboratory of Clinical Geriatric Medicine,Huadong Hospital Affiliated to Fudan University,Shanghai,200040,P.R.China;Nursing Department of Xinhong Community Health Service Center,Shanghai,200041,P.R.China)

机构地区：[1]复旦大学附属华东医院胸外科,上海老年医学重点实验室,上海200040 [2]上海新虹社区卫生服务中心护理部,200041

出　　处：《老年医学与保健》2024年第1期146-149,共4页Geriatrics & Health Care

基　　金：国家自然科学基金项目(62176063,62203117)。

摘　　要：目的分析电磁导航支气管镜辅助下联合吲哚菁绿注入法定位老年患者多发肺结节的可行性。方法2023年2月—2023年5月,复旦大学附属华东医院7例老年多发肺结节患者共15枚结节接受术前电磁导航支气管辅助下注射吲哚菁绿定位法。所有结节均为纯磨玻璃结节以及混杂磨玻璃结节。4枚结节位于右肺上叶、3枚结节位于右肺下叶、5枚结节位于左肺上叶、3枚结节位于左肺下叶。结果所有患者均在手术室全麻下完成电磁导航支气管镜并注射吲哚菁绿定位,定位结束后立刻翻身完成单孔胸腔镜肺结节切除术。其定位成功率93.3%(14/15),无磁导航定位的相关并发症发生。患者平均年龄(65.8±4.2)岁,结节大小为(12.66±3.84)mm,结节距离脏层胸膜距离为(10.77±6.87)mm,操作平均时间为(18.67±8.74)min。术后病理显示原位腺癌6例,微浸润腺癌6例和侵润性腺癌3例。结论电磁导航辅助下注射吲哚菁绿定位术是有效且安全的方法,能帮助胸外科医师快速定位老年患者多发肺结节,节约手术时间,临床上值得推广。Objective To analyze the feasibility of electromagnetic navigation bronchoscopy(ENB)-guided injection of indocyanine green(ICG)to locate multiple pulmonary nodules in elderly patients.Methods From February 2023 to May 2023,7 elderly patients with multiple pulmonary nodules underwent preoperative ENB-guided injection of ICG localization for 15 nodules in Huadong Hospital Affiliated to Fudan University.All nodules were pure ground glass nodules or mixed ground glass nodules.4 nodules were located in the upper lobe of the right lung,3 ones in the lower lobe of the right lung,5 ones in the upper lobe of the left lung,and 3 ones in the lower lobe of the left lung.Results All patients completed ENB-injection of ICG localization under general anesthesia in the operating room.After localization,the patient was immediately turned over to complete single-aperture thoracoscopic resection of pulmonary nodules.The success rate of localization was 93.3%(14/15),and there were no complications related to magnetic navigation localization.The mean age of patients was(65.8±4.2)years.The size of nodules was(12.66±3.84)mm,the distance between nodules and visceral pleura was(10.77±6.87)mm,and the average operation time was(18.67±8.74)min.The postoperative pathological results demonstrated that 6 cases were adenocarcinoma in situ,6 ones were microinvasive adenocarcinoma and 3 ones were invasive adenocarcinoma.Conclusion ENB-guided injection of ICG localization is an effective and safe method.It can help thoracic surgeons quickly locate multiple pulmonary nodules in elderly patients,save operation time,and is worth of clinical promotion.

关 键 词：老年 多发肺结节 吲哚菁绿 电磁导航支气管镜辅助 

分 类 号：R563[医药卫生—呼吸系统]