精准穿刺套针辅助CT引导经皮穿刺定位法在周围型肺微小结节术前定位中的作用

CT-Guided Percutaneous Localization with The Aid of Accurate Puncture Sleeve for Peripheral Pulmonary Micronodules Application of Precise Preoperative Location

目的探讨术中精准穿刺套针辅助CT引导经皮穿刺定位法在周围型肺部微小结节术前定位中的作用。方法对2016年9月至2019年2月低剂量螺旋CT显示需行术前CT定位的肺小结节患者,分为精准穿刺套件+传统胸腔穿刺针组(试验组)和传统胸腔穿刺针组(对照组),比较两组患者小结节穿刺的首次进针成功率、气胸发生率和术前定位成功率。结果试验组与对照组首次进针成功率为78.73%vs.48.94%(χ^2=9.034,P=0.002),无症状气胸发生率为0%vs.8.51%(χ^2=4.178,P=0.041),术前肺结节定位成功率为95.74%vs.93.62%(χ^2=0.211,P=0.646)。结论术中精准穿刺套针联合传统胸腔穿刺针辅助CT定位提高了穿刺定位的首次进针成功率,减少了气胸的发生率,值得临床运用。

Objective To investigate the application of CT guided percutaneous localization with the aid of accurate puncture sleeve in the preoperative localization of peripheral pulmonary micronodules.Method From September 2016 to February 2019,patients who had pulmonary nodules found by low dose CT and indicated for preoperative CT localization were enrolled and randomly assigned to two groups:precision puncture kit combined traditional thoracic puncture needle group(experimental group)and traditional thoracic puncture needle group(control group).The success rate of the first puncture of small nodules,the incidence of pneumothorax and the success rate of preoperative localization were compared between the two groups.Result The success rate of the first injection in the experimental group were significantly higher than the control group(78.73% vs.48.94%,P=0.002).The incidence of asymptomatic pneumothorax in the experimental group were significantly lower than the control group(0% vs.8.51%,P=0.041).The success rate of localization of pulmonary nodules before operation in the experimental group were significantly higher than the control group(95.74% vs.93.62%,P=0.646).Conclusion Accurate puncture needle combined with traditional thoracic puncture needle assisted CT localization can increase the success rate of puncture positioning for the first time and reduce the incidence of pneumothorax,which is worthy of clinical application.