CT引导下微弹簧圈定位在肺小结节楔形切除术中的应用

发布时间：2018-03-20 07:00

本文选题：肺小结节　切入点：微弹簧圈　出处：《医学影像学杂志》2016年06期 　论文类型：期刊论文

【摘要】：目的探讨CT引导下定位置入微弹簧圈在肺小结节楔形切除术中的临床应用。方法对12例肺小结节患者在CT引导下细针穿刺,采用"两步释放法":将一小部分微弹簧圈释放在病变附近5mm范围内,一部分弹簧圈留在脏层胸膜表面,根据肺小结节及弹簧圈位置来确定切除结节周围肺组织范围,在胸腔镜下行肺局部楔形切除,将离体组织进行快速冰冻、组织学观察,根据病变的良恶性指导临床继续扩大手术或结束治疗。结果 12例肺小结节行CT扫描均能清晰显示病灶,置入弹簧圈,成功术前定位,并行胸腔镜下肺楔形切除术,全组患者手术顺利,无严重手术并发症和围手术期死亡,术后病理诊断:原发性肺癌4例(33.3%),不典型腺瘤样增生2例(16.7%),错构瘤1例(8.3%),炎性病变5例(41.7%)。结论 CT引导下定位置入微弹簧圈在肺内小结节楔形切除术中的应用是安全、有效的,可以帮助胸外科医师与病理医师快速、准确找到病灶,指导临床治疗。
[Abstract]:Objective to investigate the effect of CT guided microcoil placement in small pulmonary nodules wedge resection of the clinical application of intraoperative. Methods 12 cases of pulmonary nodules in patients with CT guided fine-needle aspiration, using "two step release": a small part of microcoil release in the lesions near the 5mm range, a part of spring circle in the visceral pleural surface, according to small pulmonary nodules and coil position to determine the resected nodules surrounding lung resection range in thoracoscopic pulmonary wedge, isolated tissues were frozen, histological observation, under the guidance of clinical benign and malignant lesions continue to expand the operation or the end of treatment. Results 12 cases of pulmonary nodules section CT scan can clearly show the lesions in coils, successful preoperative localization, parallel thoracoscopic pulmonary wedge resection surgery, all patients smoothly, there were no serious complications and no perioperative death, postoperative pathological diagnosis: Primary lung cancer in 4 cases (33.3%), 2 cases of atypical adenomatous hyperplasia (16.7%), 1 cases of hamartoma (8.3%), 5 cases of inflammatory lesions (41.7%). Conclusion CT guided microcoil placement in small pulmonary nodules wedge resection is safe and effective, can help Department of thoracic surgery physicians and pathologists quickly and accurately find the lesion, guide the clinical treatment.

【作者单位】：北京市海淀医院放射科;北京市海淀医院胸外科;
【分类号】：R655.3;R816.41

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