医用胶混合亚甲蓝在肺部小结节术前定位中的应用

Application of Medical Glue Mixed With Methylene Blue Injection in Preoperative Localization for Pulmonary Small Nodules

目的探讨医用胶混合亚甲蓝在肺部小结节胸腔镜手术前定位中的应用价值。方法2018年1月~2020年11月,对81例共92枚肺小结节定位后行胸腔镜下肺结节切除术。结节直径5~20 mm,(7.8±2.9)mm。结节距离胸膜0~31 mm,(9.8±8.6)mm。术前7 d内先行CT引导医用胶混合亚甲蓝定位,继而在胸腔镜下行肺结节切除术。结果定位均成功,定位相关并发症包括少量气胸7例(7.6%),针道周围出血5例(5.4%),咯血1例(1.1%),胸膜反应1例(1.1%),胸痛3例(3.3%),呛咳并咯出少量混合胶2例(2.2%)。定位与手术间隔时间1~148 h,中位数48 h。92枚结节均成功切除,无中转开胸。结论术前CT引导下医用胶混合亚甲蓝定位肺小结节方便、安全、实用,值得推广。

Objective To evaluate the values of medical glue mixed with methylene blue injection in positioning pulmonary small nodules before video-assisted thoracoscopic surgery.Methods From January 2018 to November 2020,81 patients with 92 pulmonary small nodules underwent thoracoscopic pulmonary nodule resection after localization.The diameters of these nodules were from 5 to 20 mm,with an average of(7.8±2.9)mm.The distance of these nodules from pleura were from 0 to 31 mm,with an average of(9.8±8.6)mm.All the pulmonary nodules of these patients were positioned by the medical glue mixed with methylene blue under CT guidance within 7 d before surgery,followed by thoracoscopic pulmonary nodule resection.Results All the nodules were successfully positioned.The position-related complications included mild pneumothorax in 7 cases(7.6%),pulmonary hemorrhage along the needle path in 5 cases(5.4%),hemoptysis in 1 case(1.1%),pleural reaction in 1 case(1.1%),chest pain in 3 cases(3.3%),and cough with a small amount of mixed glue in 2 cases(2.2%).Notably,the duration between nodules position and surgery was around 1-148 h with a median of 48 h.All the 92 nodules were successfully resected without convertion to thoracotomy during the process.Conclusion CT-guided pulmonary nodules position with medical glue mixed with methylene blue injection before surgery is a convenient,safe,and practicable method,which is worthy of promotion.