论文部分内容阅读
目的:评价肺小结节(SPN)胸腔镜术前低剂量CT(LDCT)引导下Hook-wire定位的临床应用价值。方法:45例患者46个SPN行胸腔镜手术(VATS)肺楔形切除术,术前皆行LDCT引导下Hook-wire定位。SPN直径4～10mm,平均8.3mm,距壁层胸膜5～28mm。根据手术结果,评价术前LDCT引导下Hook-wire定位技术的失败率、并发症及住院时间等。结果:LDCT引导下Hook-wire定位成功率为100%,定位时间13～45min,平均22min。21例(46.7%)发生并发症,其中19例(42.2%)无症状气胸,6例(13.3%)无症状出血,4例(8.9%)同时发生气胸和出血。VATS时间14～75min,平均29min。术中出血量25～45mL,住院时间5～14d。SPN的组织学诊断为原位腺癌10例,微浸润腺癌8例,肺腺癌6例,肺鳞癌2例,不典型腺瘤样增生8例,肺转移瘤2例,良性病灶10例。结论:LDCT引导下Hook-wire定位SPN的准确率高,并发症轻微,对于VATS术前定位具有指导意义和临床价值。
Objective: To evaluate the clinical value of Hook-wire localization guided by low-dose CT (LDCT) before pulmonary thoracic nodule (SPN). METHODS: Forty-six patients underwent thoracoscopic surgery (VATS) for 45 spondylo-spondylectomies. Hook-wire was performed under LDCT before surgery. SPN diameter of 4 ~ 10mm, an average of 8.3mm, parietal pleura 5 ~ 28mm. According to the results of surgery, preoperative LDCT-guided Hook-wire positioning technology failure rate, complications and hospitalization time. Results: The success rate of Hook-wire positioning guided by LDCT was 100%. The positioning time was 13-45 minutes with an average of 22 minutes. Twenty-one patients (46.7%) had complications, of which 19 (42.2%) had asymptomatic pneumothorax, 6 (13.3%) had asymptomatic hemorrhage and 4 (8.9%) had pneumothorax and hemorrhage at the same time. VATS time 14 ~ 75min, an average of 29min. Intraoperative bleeding 25 ~ 45mL, hospital stay 5 ~ 14d. The histological diagnosis of SPN in situ adenocarcinoma in 10 cases, 8 cases of micro-invasive adenocarcinoma in 6 cases, lung adenocarcinoma in 2 cases, squamous cell carcinoma in 2 cases, atypical adenomatous hyperplasia in 8 cases, 2 cases of lung metastases, benign lesions 10 example. Conclusion: The accuracy of Hook-wire positioning SPN guided by LDCT is high, and the complication is mild. It is instructive and clinical value for preoperative localization of VATS.