CT引导下微弹簧圈定位在肺小结节胸腔镜术中的临床应用

发布时间：2018-04-05 07:45

本文选题：肺小结节　切入点：胸腔镜手术　出处：《介入放射学杂志》2017年06期

【摘要】：目的探讨电视胸腔镜手术(VATS)前CT引导下微弹簧圈定位肺小结节(SPN)对精准切除病灶的临床价值。方法回顾性分析2014年6月至2016年5月,90例行VATS切除孤立性SPN患者的资料。其中45例患者术前行微弹簧圈定位(A组),45例患者未行术前定位(B组)。统计分析两组VATS肺叶楔形切除时间、转开胸手术率、术后住院时间,以及微弹簧圈定位病灶的成功率、并发症等,评价术前微弹簧圈定位病灶的安全性及其对VATS术的增益价值。结果 A组VATS术成功率100%;SPN病灶定位成功率95.6%,术后出现气胸5例、肺表面出血6例、弹簧圈脱落2例等并发症。B组VATS手术成功率84.4%,中转开胸率15.6%。A组VATS手术时间(17.7±2.8)min、术后住院时间(6.2±1.7)d及中转开胸0例明显低于B组,差异具有统计学意义(P0.05)。结论 CT引导下微弹簧圈定位,可辅助VATS快速、精确切除肺内小病灶,能有效降低中转开胸率、缩短VATS手术时间及术后住院时间。
[Abstract]:Objective to evaluate the clinical value of SPNs in accurate resection of pulmonary nodules under CT guidance before video-assisted thoracoscopic surgery (VATS).Methods from June 2014 to May 2016, 90 patients with isolated SPN underwent VATS resection.Among them, 45 patients were treated with microcoils before operation.The time of wedge resection of pulmonary lobe, the rate of conversion to thoracotomy, the postoperative hospitalization time, the success rate and complications of microcoil localization were statistically analyzed in both groups. The safety of preoperative microcoils localization and its value in the gain of VATS were evaluated.Results in group A, the success rate of VATS operation was 95.6%, pneumothorax occurred in 5 cases, and pulmonary hemorrhage occurred in 6 cases.The success rate of VATS operation in group B was 84.4, the rate of conversion to open chest was 15.6 卤2.8 minutes, the postoperative hospitalization time was 6.2 卤1.7 days and the conversion to thoracotomy in group B was significantly lower than that in group B (P 0.05), and the operative time of operation was 17.7 卤2.8 min in group A. the postoperative hospitalization time was 6.2 卤1.7 days and the conversion to thoracotomy in group B was significantly lower than that in group B (P 0.05).Conclusion CT guided microcoils localization can assist VATS to remove small pulmonary lesions quickly and accurately. It can effectively reduce the rate of conversion to thoracotomy and shorten the operation time and postoperative hospitalization time of VATS.
【作者单位】：昆明医科大学第一附属医院医学影像科;
【分类号】：R655.3;R816.41

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