CT引导下Hookwire及亚甲蓝定位在肺部小结节胸腔镜术前应用

Application of preoperative CT-guided Hookwire and methylxanthine chloride in treatment of small pulmonary nodule patients with thoracoscopy

目的探讨CT引导下Hookwire与亚甲蓝定位在肺部小结节胸腔镜术前的应用价值。方法选取2011年10月—2013年5月在本院胸外科治疗的69例患者,分别在CT引导下对其75处肺小结节行Hookwire、亚甲蓝单独定位以及Hookwire、亚甲蓝联合定位,并行全电视胸腔镜肺叶切除术(VATS),其中Hookwire21例,22个病灶(A组);亚甲蓝20例,21个病灶(B组);Hookwire联合亚甲蓝28例,32个病灶(C组)。定位后行楔形切除或肺叶切除术,对照3组的定位成功率。结果 A组定位成功18个病灶(81.8%),脱落及未刺破胸膜4个病灶;B组定位成功18个病灶(85.7%),3个病灶显示不清;C组定位成功32个病灶(100%)。A、B 2组间差异无统计学意义(P>0.05);A、B组与C组间差异有统计学意义(P<0.05)。结论肺部小结节胸腔镜术前CT引导下Hookwire、亚甲蓝单独定位的成功率稍低,Hookwire与亚甲蓝联合定位成功率高达100%,可提高VATS下切除孤立性肺结节的准确率。

Objective To explore the clinical value of preoperative CT - guided Hookwire and methylxanthine chloride in the treatment of small pulmonary nodules（ 〈 3 cm） patients with video- assisted thoracic surgery（VATS）. Methods 69 patients （75 small pulmonary nodules） un- derwent VATS wedge resection by using preoperative CT- guided positioning were collected and di- vided into 3 groups. Group A was treated with Hookwire localization only （21 patients, 22 lesions）, group B was treated with methylxanthine chloride combined staining（20 patients, 21 lesions）, and group C was treated with a combination of Hookwire localization, methylxanthine chloride and staining（28 patients, 32lesions）. Results The accuracy rates of 3 groups were 81.8% （18/22）, 85.7 % （ 18/21 ） and 100 % （32/32） respectively. There was no significant difference between group A and group B （P 〉 0.05）, and there was significant difference between group A、 B and group C （P 〈 0.05 ）. Conclusion Application of preoperative CT - guided Hookwire localization and methylxanthine chloride combined staining in the treatment of the small pulmonary nodules patients with VATS can increase the accuracy rate of resection of solitary pulmonary nodules.