3D-CTBA联合肺循环单向阻断法在胸腔镜肺段切除术中的应用效果  

Application effect of 3D-CTBA combined with pulmonary circulation one-way blocking method in thoracoscopic segmentectomy

作　　者：刘江超 吕忠柱 邓意平 杨富瑜 毕磊 LIU Jiangchao;LYU Zhongzhu;DENG Yiping;YANG Fuyu;BI Lei(Thoracic and Cardiovascular Surgery Department,Bishan Hospital of Chongqing Medical University,Chongqing 402760,China)

机构地区：[1]重庆医科大学附属璧山医院胸心血管外科,重庆402760

出　　处：《临床医学研究与实践》2025年第10期50-53,共4页Clinical Research and Practice

基　　金：重庆市璧山区社会民生领域科技计划项目(No.BSKJ2022017)。

摘　　要：目的探讨三维CT支气管血管成像(3D-CTBA)联合肺循环单向阻断法在胸腔镜肺段切除术中的应用价值。方法纳入2023年1月至2024年7月我院收治的90例拟行胸腔镜肺段切除术的肺结节患者,采用随机数字表法将其分为观察组(n=45)和对照组(n=45)。观察组术前实施3D-CTBA三维重建规划,术中采用肺循环单向阻断法;对照组行常规胸腔镜肺段切除术,术中采用传统膨胀-萎陷法识别段间平面。比较两组的临床效果。结果观察组的手术时间、术后带管时间、术后住院时间短于对照组,术中出血量少于对照组(P<0.05)。术后1、3个月,观察组的第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)及最大通气量(MVV)高于对照组(P<0.05)。观察组的肺不张、咯血、术中扩大切除范围发生率低于对照组(P<0.05)。结论3D-CTBA联合肺循环单向阻断法可显著提高肺段解剖结构的术中辨识度,实现精准的解剖性肺段切除,有效优化围术期临床指标,降低术后并发症发生风险。Objective To explore the application value of 3D-computed tomography bronchography and angiography(3D-CTBA)combined with pulmonary circulation one-way blocking method in thoracoscopic segmentectomy.Methods A total of 90 patients with pulmonary nodules who underwent thoracoscopic segmentectomy in our hospital from January 2023 to July 2024 were enrolled.The patients were divided into observation group(n=45)and control group(n=45)by random number table method.In the observation group,3D-CTBA three-dimensional reconstruction planning was performed before operation,and pulmonary circulation one-way blocking method was used during operation;the control group underwent conventional thoracoscopic segmentectomy,and the intersegmental plane was identified by traditional expansion-deflation method.The clinical effects of the two groups were compared.Results The operation time,postoperative catheterization time and postoperative hospitalization time of the observation group were shorter than those of the control group,and the intraoperative blood loss was less than that of the control group(P<0.05).At 1 and 3 months after operation,the forced expiratory volume in one second(FEV_(1)),forced vital capacity(FVC)and maximal voluntary ventilation(MVV)in the observation group were higher than those in the control group(P<0.05).The incidences of atelectasis,hemoptysis and intraoperative extended resection range in the observation group were lower than those in the control group(P<0.05).Conclusion 3D-CTBA combined with pulmonary circulation one-way blocking method can significantly improve the intraoperative identification of the anatomical structure of the pulmonary segment,achieve accurate anatomical segmentectomy,effectively optimize perioperative clinical indicators,and reduce the risk of postoperative complications.

关 键 词：肺结节 三维CT支气管血管成像 胸腔镜肺段切除术 肺循环单向阻断法 

分 类 号：R734.2[医药卫生—肿瘤]