肺结节术前CT引导下新型结节定位针定位临床研究

Clinical study on preoperative CT-guided localization of pulmonary nodule with new pulmonary nodule locating needle

目的研究肺结节术前CT引导下新型结节定位针定位的临床应用价值。方法40例肺结节患者,根据定位方式不同分为对照组(17例)与观察组(23例)。对照组患者采用CT引导下带钩金属丝(Hookwire)定位针定位,观察组患者采用CT引导下新型结节定位针定位。比较两组穿刺情况,分析手术结果及病理结果。结果观察组肺结节定位时间(10.02±1.72)min明显短于对照组的(11.53±1.75)min,脱钩率0明显低于对照组的14.29%,差异均有统计学意义(P<0.05);两组肺出血率及气胸率比较差异无统计学意义(P>0.05)。对全部患者进行肺段或者肺楔形切除术,共计切除肺结节44枚,切除率达91.67%,肺叶切除术共计切除肺结节4枚,切除率达8.33%,无中转开腹手术。40例患者中非典型性腺瘤样增生2例、炎性病变3例、浸润性腺癌7例、微浸润腺癌7例、浸润性腺癌2例,原位腺癌19例。结论与CT引导下Hookwire定位针定位相比,CT引导下新型结节定位针定位的脱钩风险更低,而且定位用时更短,具有较高的推广价值,值得应用。

Objective To study the clinical value of preoperative CT-guided localization of pulmonary nodule with new nodule locating needle.Methods A total of 40 patients with pulmonary nodules were divided into a control group(17 patients)and an observation group(23 patients)according to the different localization methods.Patients in the control group were localized with a Hookwire needle under CT guidance,and patients in the observation group were localized with new pulmonary nodule locating needle under CT guidance.The punctures of the two groups were compared,and the surgical results and pathological findings were analyzed.Results The localization time of pulmonary nodules was(10.02±1.72)min in the observation group,which was significantly shorter than that of(11.53±1.75)min in the control group;the Hookwire dislodgement rate was 0 in the observation group,which was significantly lower than that of 14.29%in the control group;all differences were statistically significant(P<0.05).The differences in the rates of pulmonary hemorrhage and pneumothorax between the two groups were not statistically significant(P>0.05).A total of 44 pulmonary nodules were resected by lung segmental or wedge resection in all patients,with a resection rate of 91.67%,and a total of 4 pulmonary nodules were resected by lobectomy,with a resection rate of 8.33%,with no conversion to open surgery.There were 2 cases of non-typical adenomatous hyperplasia,3 cases of inflammatory lesions,7 cases of invasive adenocarcinoma,7 cases of microinvasive adenocarcinoma,2 cases of invasive adenocarcinoma,and 19 cases of adenocarcinoma in situ in 40 patients.Conclusion Compared with CT-guided Hookwire needle localization,CT-guided localization with new pulmonary nodule locating needle has a lower risk of Hookwire dislodgement and takes less time to localize,so it has a higher promotion value and is worthy of application.