摘要
目的探究CT引导下带钩钢丝定位针技术在电视胸腔镜手术(VATS)术前定位肺部磨玻璃结节(GGN)中的临床价值。方法回顾性分析2017年6月至2020年7月本院收治的80例肺部磨玻璃结节患者临床资料,依据随访资料分为试验组(VATS术前采用CT引导下带钩钢丝定位针技术定位)和对照组(VATS术前未采取CT引导下带钩钢丝定位针技术定位),评估CT引导下带钩钢丝定位针技术在VATS术前定位GGN中的有效性和安全性。结果试验组手术时间、住院时间较对照组明显短,术中出血量、中转开胸率明显低于对照组,差异有统计学意义(P<0.05)。试验组48例GGN患者,共检出51个病灶(3例患者检出2个病灶,45例患者检出单个病灶),所有病例患者病灶均成功定位,左肺叶19个、右肺叶32个。病灶平均最大直径(1.1±0.2)cm,平均定位时间(17.4±1.7)min,平均进针深度(1.7±0.2)cm,平均进针角度(79.0±6.1)°。以术后病理结果为“金标准”,CT引导下带钩钢丝定位针技术的灵敏度、特异度、准确度分别为90.63%(29/32)、87.50%(14/16)、89.58%(43/48)。试验组术后并发症总发生率略高于对照组,但差异无统计学意义(P<0.05)。结论GGN患者于VATS术前行CT引导下带钩钢丝定位针技术定位有明确的临床手术增益价值。
Objective To explore the clinical value of CT-guided hookwire localization of pulmonary ground-glass nodules(GGN)before video-assisted thoracoscopic surgery(VATS).Methods The clinical data of 80 patients with GGN who were admitted and treated in the hospital between June 2017 and july 2020 were retrospectively analyzed.According to the follow-up data,the patients were divided into experimental group(applying CT guided hookwire localization before VATS)and the control group(without CT-guided hookwire localization before VATS).Effectiveness and safety of CT-guided hookwire localization of GGN before surgery were evaluated.Results The operation time and hospital stay of the experimental group were significantly shorter than those of the control group,and the intraoperative blood loss and the rate of conversion to thoracotomy were significantly less/lower than those of the control group(P<0.05).A total of 51 lesions were detected in 48 patients with GGN in the experimental group(3 patients with 2 lesions and 45 patients with single lesion).The lesions of all patients were successfully located,with 19 in left lung lobes and 32 in right lung lobes.The average maximum diameter,average localization time,average needle insertion depth and average needle insertion angle were(1.1±0.2)cm,(17.4±1.7)min,(1.7±0.2)cm and(79.0±6.1)°,respectively.With postoperative pathological results as the"golden standard",the sensitivity,specificity and accuracy of CT-guided hookwire localization were 90.63%(29/32),87.50%(14/16)and 89.58%(43/48),respectively.The total incidence of postoperative complications in the experimental group was slightly higher than that in the control group,but the difference was not statistically significant(P>0.05).Conclusion CT-guided hookwire localization of GGN before VATS can obtain clear clinical benefits.
作者
陈颖
李先华
钱涵泓
郁骁
刘为毛
CHEN Ying;LI Xian-hua;QIAN Han-hong;YU Xiao;LIU Wei-mao(Department of Thoracic Surgery,Wuxi Hospital Affiliated to Nanjing University of Chinese Medicine,Wuxi 214000,Jiangsu Province,China)
出处
《中国CT和MRI杂志》
2022年第3期46-48,共3页
Chinese Journal of CT and MRI
作者简介
第一作者/通讯作者:陈颖,男,主治医师,主要研究方向:肺部结节的诊断及微创手术治疗。E-mail:chenying_007@126.com。
