术前CT引导穿刺定位并亚甲蓝染色在胸腔镜治疗肺部小结节中的应用

The application of preoperative CT-guided puncturing and methylxanthine chloride staining in treatment of the small pulmonary nodules with video assistant thoracic surgery

目的探讨CT引导下肺小结节穿刺并亚甲蓝染色定位在胸腔镜切除中的临床价值。方法我院58例患者,行CT引导Hookwire系统与亚甲蓝染色联合定位,后行胸腔镜下肺楔形切除术,若术中快速病理为肺癌则行完全胸腔镜肺叶切除术。统计穿刺定位时间、并发症,肺楔形切除术时间等。结果穿刺定位时间20.18±5.39 min,少量气(9/58),胸膜反应(2/58),血胸或血气胸(2/58);肺楔形切除时间15.71±4.25 min。结论术前CT引导穿刺并亚甲蓝染色定位肺小结节方法准确率高,并发症少,提高成功率,对肺小结节诊断及治疗具有很好的临床价值。

Background The aim of this study was to analyze the clinical value of preoperative CT-guided puncturing and methylxan- thine chloride staining in treatment of the small pulmonary nodules （ diameter 〈 3 cm） with video assistant thoracic surgery （VATS）. Methods A retrospective review of the medical records of 58 patients with the small pulmonary nodules undergoing VATS wedge resection using preoperative CT-guided puncturing and methylxanthine chloride staining was performed. Total VATS lobectomy were performed when the pathological outcomes were primary lung carcinoma. The time of puncturing and surgery, achievement ratio, and the complications were summarized and analyzed. Results Time of puncturing was 20. 18 ＋ 5.39 min, the complications including pnenmothorax, pleura reaction, puncturing failure, the Hookwire needle loss. Time of surgery was 15.71 ~ 4.25 min. Conclusions The application of preoper- ative CT-guided puncturing and methylxanthine chloride staining in treatment of the small pulmonary nodules with video assistant thoracic surgery can increase the ratio of lung wedge resection with little complications, and may be better used in clinical diagnosis and treatment of small pulmonary nodules with VATS.