近红外荧光胸腔镜在胸交感神经节显像中的应用

Application of near-infrared fluorescent thoracoscope in visualizing thoracic sympathetic ganglions

目的探索近红外荧光胸腔镜在胸交感神经特异性显影中的应用，验证荧光胸腔镜胸交感神经显影的有效性和安全性。方法纳入31例2015年9月到2016年9月间接受荧光胸腔镜手术的患者，男12例，女19例，平均年龄47岁。术前24h静脉滴注吲哚菁绿5mg／kg，术中用荧光胸腔镜系统分别在白光和荧光模式下对胸交感神经节进行观察，术后分析胸交感神经链显影的视频及照片，评价显影效果，记录交感神经节与相应肋骨的关系。结果31例中可清晰观察到123枚神经节，未观察到药物相关不良反应。其中48．8％交感神经节位于下位肋骨上缘，26．9％的T2神经节位于第3肋骨表面，23．1％的T3神经节位于第4肋骨表面。图像分析软件显示荧光下神经节的平均信背比为1．67。结论荧光胸腔镜可安全有效的实时显影交感神经节，通过荧光胸腔镜有望指导实施精确化的手汗症胸交感神经切断术。

Objective Application of near-infrared fluorescent thoracoscope in visualizing thoracic sympathetic ganglions, to explore the effectiveness and safety of the technique. Methods Patients received near-infrared fluorescent thoracoscopic surgery was continuously in rolled from September 2015 to September 2016. The patient was infused indocyanine green 5 mg intravenous 24 hours before surgery. The thoracic sympathetic ganglions were observed under white and fluorescence model during surgery. The videos and photos were analyzed and the relationship between sympathetic ganglions and ribs was recorded. Results 31 patients was in roiled, including 12 males and 19 females. The average age was 47 years. The sympathetic gangli- on of each patient was well visualized under fluorescence model. The signal to background ratio was 1.67. As we found that 48.8% ganglions located in the upper edge of lower rib. Besides, 26.9% of T2 ganglions and 23.1% of T3 ganglions located on the rib. Conclusion Near-infrared fluorescent thoracoscope was effiective and safety to visualize the thoracic sympathetic ganglions. The sympathectomy of palmar hyperhidrosis could be done by near-infrared fluorescent thoracoscope more precisely.