肺循环单向阻断段间平面识别法在肺段切除术中的应用

Application of pulmonary circulation single-blocking method in intersegmental plane identification during segmentectomy

目的介绍一种胸腔镜肺段切除术中利用靶段肺循环单向阻断识别段间平面的新方法。方法回顾性分析2019年1月—2020年3月因肺结节就诊于重庆医科大学附属第一医院同一医疗组使用肺循环单向阻断法行胸腔镜下肺段切除术83例患者的临床资料,其中男33例、女50例,中位年龄54(46~65)岁。根据术中单向阻断靶段动脉或静脉的不同将患者分为两组:单向阻断静脉组(single vein group,SVG,n=31)和单向阻断动脉组(single artery group,SAG,n=52),记录两组患者的临床资料并行比较分析。结果两组患者术中均显示出清晰段间平面。两组在段间平面离断方式(P=0.823)、手术时间(P=0.786)、术中出血量(P=0.775)、胸腔引流管引流时间(P=0.659)、术后住院时间(P=0.824)以及术后并发症发生率(P=1.000)等方面差异均无统计学意义。结论在胸腔镜肺段切除术中使用肺循环单向阻断法进行段间平面识别简单可行,术中单向阻断靶肺动脉或静脉均能达到满意的段间平面识别效果。

Objective To introduce a new method for identifying intersegmental planes during thoracoscopic segmentectomy using pulmonary circulation single-blocking in the target segment.Methods To retrospectively analyze the clinical data of 83 patients who underwent thoracoscopic pulmonary segmentectomy from January 2019 to March 2020 using the pulmonary circulation single-blocking method.There were 33 males and 50 females,with a median age of54(46-65)years,and they were divided into a single vein group(SVG,n=31)and a single artery group(SAG,n=52),and the clinical data of two groups were compared.Results The intersegmental planes were identified successfully in both groups and there were no statistically significant differences between the two groups in terms of intersegmental plane management(P=0.823),operating time(P=0.786),intraoperative blood loss(P=0.775),chest drainage time(P=0.659),postoperative hospital stay(P=0.824)or the incidence of postoperative complications(P=1.000).Conclusion The use of pulmonary circulation single-blocking for intersegmental plane identification during thoracoscopic segmentectomy is safe and feasible,and the intersegmental plane can be satisfactorily identified by the single-blocking of arteries or veins.