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目的探讨CT引导美蓝染色定位法在肺磨玻璃样微小结节(small ground glass opacity,sGGO)术前精确定位中的临床应用及效果。方法肺磨玻璃样微小结节患者79例,均于术前行CT引导美蓝染色定位后,然后采取电视辅助胸腔镜手术(video assisted thoracic surgery,VATS)肺楔形切除,根据术中快速冰冻切片病理结果决定下一步手术方式。评估美蓝染色定位准确率、并发症发生率、定位后至VATS平均间隔时间、中转开胸率、术后平均住院时间以及术后病理分型。结果美蓝染色定位准确率为100.0%,出现大咯血1例(1.2%),少量气胸13例(16.0%),胸膜反应2例(2.5%),定位后至VATS平均间隔时间为(62.5±15.3)分钟,中转开胸2例,术后平均住院时间(7.0±1.5)天。术后病理检查结果为原发性肺癌51例,良性病变27例,未发现病灶1例。结论 CT引导美蓝染色定位应用于肺磨玻璃样微小结节的术前定位,能够准确显示病变区域。
Objective To investigate the clinical application and effect of CT-guided methylene blue staining in preoperative localization of small ground glass opacity (sGGO). Methods Sixty-nine patients with lung-milled vitreous nodules underwent lung wedge resection with video-guided thoracic surgery (VATS) after preoperative CT-guided methylene blue staining. According to the rapid frozen section Pathological results determine the next step of surgery. To assess the accuracy of methylene blue staining, the incidence of complications, the average time between post-localization and VATS, the rate of thoracotomy, the average postoperative hospital stay and postoperative pathological classification. Results The accuracy rate of methylene blue staining was 100.0%. One case had hemoptysis (1.2%), 13 cases (16.0%) had small amount of pneumothorax and 2 cases (2.5%) had pleural reaction. The average interval between the time of positioning and VATS was (62.5 ± 15.3) minutes, 2 cases were transferred to thoracotomy, and the average postoperative hospital stay was (7.0 ± 1.5) days. Postoperative pathological findings of 51 cases of primary lung cancer, benign lesions in 27 cases, no lesions were found in 1 case. Conclusions CT-guided methylene blue staining can be used to preoperatively locate the lung-shaped glass-like microtumor nodules and accurately display the lesion area.