CT引导下细针穿刺定位胸腔镜手术治疗肺部孤立性微小结节患者的效果

Effects of thoracoscopic surgery after CT-guided fine needle aspiration localization on patients with solitary pulmonary mini-nodules

目的:观察CT引导下细针穿刺定位胸腔镜手术治疗肺部孤立性微小结节患者的效果。方法:选取2019年7月至2020年5月该院收治的82例肺部孤立性微小结节患者进行前瞻性研究,按照随机数字表法分成对照组和观察组各41例。对照组实施开胸手术治疗,观察组实施经CT引导细针穿刺定位胸腔镜手术治疗。比较两组临床疗效、手术相关指标水平、并发症发生率、复发率及病死率。结果:观察组治疗总有效率为97.56%,高于对照组的60.98%,差异有统计学意义(P<0.05);观察组术中出血量少于对照组,住院时间、胸管引流时间、手术时间、镇痛时间均短于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为2.44%,低于对照组的19.51%,差异有统计学意义(P<0.05);观察组复发率为4.88%,低于对照组的21.95%,差异有统计学意义(P<0.05);两组病死率比较,差异无统计学意义(P>0.05)。结论:CT引导下细针穿刺定位胸腔镜手术治疗肺部孤立性微小结节患者,可提高临床疗效,改善预后,降低并发症发生率和复发率,其效果优于开胸手术治疗。

Objective: To observe effects of thoracoscopic surgery after CT-guided fine needle aspiration localization on patients with solitary pulmonary mini-nodules. Methods: A prospective study was conducted on 82 patients with solitary pulmonary mini-nodules admitted to the hospital from July 2019 to May 2020. They were divided into control group and observation group according to the random number table method, 41cases in each. The control group was treated with thoracotomy, while the observation group was treated with thoracoscopic surgery after CT-guided fine needle aspiration localization. The clinical efficacy, the surgical related indicator levels, the incidence of complications, the recurrence rate and the mortality rate were compared between the two groups. Results: The total effective rate of treatment in the observation group was 97.56%, which was higher than 60.98% in the control group, and the difference was statistically significant(P<0.05). The intraoperative blood loss, the hospitalization time, the chest tube drainage time, the operation time and the analgesia time in the observation group were shorter than those in the control group, and the differences were statistically significant(P<0.05). The lower incidence of complications of the observation group was 2.44%, which was lower than 19.51% in the control group, and the difference was statistically significant(P<0.05). The recurrence rate of the observation group was 4.88%, which was lower than 21.95% in the control group, and the difference was statistically significant(P<0.05). However, there was no significant difference in mortality between the two groups(P>0.05). Conclusions: Thoracoscopic surgery after CT-guided fine needle aspiration localization for the patients with solitary pulmonary mini-nodules can improve the clinical efficacy, promote the prognosis, and reduce the incidence of complications and the recurrence rate. Moreover, it is superior to thoracotomy.