肺外1/3组和肺内2/3组肺结节影像学特征及手术方式的比较  

Imaging characteristics and surgical methods of pulmonary nodules located in external lung 1/3 group versus internal lung 2/3 group

作　　者：刘德浩[1,2] 廖良忠 李璞宸[1] 刘越 陈丽春 LIU Dehao;LIAO Liangzhong;LI Puchen;LIU Yue;CHEN Lichun(Department of Radiology,The First Affiliated Hospital of Xiamen University,School of Medicine,Xiamen University,Xiamen,361003,Fujian,P.R.China;The Third Clinical Medical College,Fujian Medical University,Fuzhou,350122,P.R.China;Department of Radiology,Xiamen Hospital of Traditional Chinese Medicine,Xiamen,361003,Fujian,P.R.China)

机构地区：[1]厦门大学附属第一医院放射科厦门大学医学院,福建厦门361003 [2]福建医科大学第三临床学院,福州350122 [3]厦门市中医院放射科,福建厦门361003

出　　处：《中国胸心血管外科临床杂志》2025年第2期180-184,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的比较肺外1/3组与肺内2/3组肺结节的影像学特征及手术方式。方法回顾性收集2020年9月—2022年4月在厦门大学附属第一医院放射科行胸腔镜术前CT引导下肺结节定位患者的临床资料。结果共纳入患者215例(共247个肺结节),其中男70例、女145例,中位年龄48岁。根据CT引导下定位的结节位置,将位于肺外带1/3处的肺结节纳入肺外1/3组,将位于中带1/3处及内带1/3处的结节纳入肺内2/3组。两组患者一般临床资料特征、肺结节性质、肺结节的肺叶分布、定位时间以及定位并发症差异无统计学意义(P>0.05)。两组患者肺结节距胸膜的距离[0.6(0.0~1.9)cm vs.1.8(0.0~4.5)cm,P<0.001]、肺结节大小[0.7(0.2~1.8)cm vs.1.0(0.2~2.0)cm,P<0.001]、手术方式(P=0.002)差异有统计学意义。肺外1/3组中92.1%的肺结节采用胸腔镜下肺楔形切除术,其他术式较少采用;肺内2/3组中77.1%的肺结节采用胸腔镜下肺楔形切除术,19.3%采用肺段切除术。结论肺外1/3组与肺内2/3组肺结节的结节直径、结节距胸膜的距离和手术方式不同,胸外科医生可根据肺结节分布的位置和大小,制定更精确的手术计划。Objective To compare the imaging characteristics and surgical methods of pulmonary nodules in the external 1/3 group and internal 2/3 group.Methods A retrospective analysis of clinical data from patients who underwent thoracoscopic preoperative CT-guided lung nodule localization at the Department of Radiology,the First Affiliated Hospital of Xiamen University from September 2020 to April 2022 was conducted.Results A total of 215 patients were enrolled(247 pulmonary nodules),including 70 males and 145 females,with a median age of 48 years.Based on the location of the nodules under CT guidance,those located in the external 1/3 area of the lung were classified into an external 1/3 group,while those located in the middle 1/3 and inner 1/3 areas were classified into an internal 2/3 group.There was no statistical difference between the two groups in terms of general clinical data,nature of pulmonary nodules,distribution of pulmonary nodules in lobes,localization time,or localization complications(P>0.05).However,there were statistical differences in the distance of pulmonary nodules from the pleura[0.6(0.0-1.9)cm vs.1.8(0.0-4.5)cm,P<0.001],size of pulmonary nodules[0.7(0.2-1.8)cm vs.1.0(0.2-2.0)cm,P<0.001],and surgical methods(P=0.002).In the external 1/3 group,92.1%of nodules underwent thoracoscopic wedge resection,while fewer patients underwent other procedures;in the internal 2/3 group,77.1%of nodules underwent thoracoscopic wedge resection,and 19.3%underwent segmentectomy.Conclusion The diameter of pulmonary nodules,the distance of pulmonary nodules from the pleura,and surgical methods differ between the external 1/3 group and internal 2/3 group.Thoracic surgeons can develop more precise surgical plans based on the location and size of pulmonary nodules.

关 键 词：CT引导下定位 肺结节 电视辅助胸腔镜手术 影像学特征 手术方式 

分 类 号：R734.2[医药卫生—肿瘤]