电磁导航支气管镜引导下肺结节定位和CT引导下Hook-wire穿刺定位在肺癌根治术中的应用效果及安全性比较  

Comparison of the efficacy and safety of electromagnetic navigation bronchoscopy-guided pulmonary nodule localization and CT-guided Hook-wire puncture localization in radical resection of lung cancer

作　　者：郑晓东[1] 聂世威 周军正 岳光成[1] 张卫民[1] ZHENG Xiaodong;NIE Shiwei;ZHOU Junzheng;YUE Guangcheng;ZHANG Weimin(Department of Thoracic Surgery,Anyang Cancer Hospital,Anyang 455000,He’nan,China)

机构地区：[1]安阳市肿瘤医院胸外科,河南安阳455000

出　　处：《癌症进展》2024年第16期1814-1817,共4页Oncology Progress

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20210877)。

摘　　要：目的对比电磁导航支气管镜(ENB)引导下肺结节定位和CT引导下Hook-wire穿刺定位在肺癌根治术中的应用效果和安全性。方法将87例行肺癌根治术患者根据定位方式的不同分为CT组(n=45,行CT引导下Hook-wire穿刺定位)和ENB组(n=42,行ENB引导下肺结节定位)。比较两组患者手术情况、切缘阳性率、心肺功能指标、应激指标和并发症发生情况。结果ENB组患者定位时间、定位后等待时间均短于CT组,差异均有统计学意义(P﹤0.05)。术后7天,两组患者左心室射血分数(LVEF)、每搏量(SV)、用力肺活量(FVC)均较术前降低,但ENB组患者LVEF、SV、FVC均高于CT组,差异均有统计学意义(P﹤0.05)。术后1天,两组患者白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、C反应蛋白(CRP)、皮质醇(Cor)水平均较术前升高,但ENB组患者IL-6、IL-8、CRP、Cor水平均低于CT组,差异均有统计学意义(P﹤0.05)。两组患者并发症总发生率比较,差异无统计学意义(P﹥0.05)。结论相比于CT引导下Hook-wire穿刺定位,ENB引导下肺结节定位的定位时间和定位后等待时间更短,能够更加有效地改善患者的心肺功能,减轻应激反应。Objective To compare the efficacy and safety of electromagnetic navigation bronchoscopy(ENB)-guided pulmonary nodule localization and CT-guided Hook-wire puncture localization in radical resection of lung cancer.Meth-od A total of 87 patients undergoing radical resection of lung cancer were divided into CT group(n=45,CT-guided Hook-wire puncture localization)and ENB group(n=42,ENB-guided pulmonary nodule localization)according to differ-ent localization methods.The surgical status,positive rate of incisal margin,cardiopulmonary function index,stress index and complications were compared between the two groups.Result The localization time and waiting time after localiza-tion in ENB group were shorter than those in CT group,and the differences were statistically significant(P<0.05).Seven days after surgery,left ventricular ejection fraction(LVEF),stroke volume(SV)and forced vital capacity(FVC)in two groups were lower than those before surgery,but LVEF,SV and FVC in ENB group were higher than those in CT group,and the differences were statistically significant(P<0.05).One day after surgery,the levels of interleukin-6(IL-6),inter-leukin8(IL-8),C-reactive protein(CRP)and cortisol(Cor)in two groups were higher than those before surgery,but the levels of IL-6,IL-8,CRP and Cor in ENB group were lower than those in CT group,and the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion Compared with CT-guided Hook-wire puncture localization,ENB-guided pulmonary nodal local-ization has shorter localization time and waiting time after localization,which can more effectively improve patients’car-diopulmonary function and reduce stress response.

关 键 词：电磁导航支气管镜引导下肺结节定位 CT引导下Hook-wire穿刺定位 肺癌根治术 定位时间 

分 类 号：R734.2[医药卫生—肿瘤]