支气管超声引导超细支气管镜联合亚甲蓝定位下电视胸腔镜手术对肺部小结节的临床价值

Value of endobronchial ultrasound-guided localization with combination of ultrathin bronchoscope and methylene bluefor small pulmonary nodules before video-assisted thoracoscopic surgery

目的探讨支气管超声引导超细支气管镜（endobronchial ultrasound-guided ultrathin bron-choscope，EUGUB）联合亚甲蓝定位在电视胸腔镜（video-assisted thoracoscopic surgery，VATS）下肺部小结节切除术中的临床价值。方法选择60例行VATS手术的肺部小结节患者，术前行EUGUS联合亚甲蓝定位。评价定位准确率、并发症发生率及术后病理等。结果EUGUB联合亚甲蓝定位准确率91．7％，咯血2例，无需特殊处理。术后病理结果证实恶性病灶43例（71．7％），良性病灶17例（28．3％）。结论术前EUGUB联合亚甲蓝定位法准确率高，并发症少，对肺部小结节的胸腔镜手术诊治有一定的临床应用价值。

Objective To analyze the value of endobronchial ultrasound-guided uhrathin bronchoscope （EUGUB） and methylene blue positioning video-assisted thoracoscopic surgery（VATS） for small pulmonary nodules. Methods Sixty patients undergoing VATS, using pre-operative EUGUB combination with methylene blue was performed. The positioning accuracy, the complications and pathological classification were analyzed. Results EUGUB combination with methylene blue positioning ac- curacy was 91.7%, meanwhile, 2 patients with hemoptysis with no conservative treatment. The postoperative histological pa- thology results showed that benign lesions and malignant lesions accounted for 28.3% and 71.7%, respectively. Conclusion The method of EUGUB combination with methylene blue in positioning of the small pulmonary nodules increases the achieve- ment ratio of VATS with few complications, and may be widely used in treatment of small pulmonary nodules with VATS.