双极激光定位导航仪在深部肺结节经皮穿刺活检中的应用

Application of bipolar laser localization navigator in percutaneous biopsy of deep pulmonary nodules

目的分析双极激光定位导航仪在深部肺结节经皮穿刺活检中的应用效果。方法选择2020年1月至2022年8月溧阳市人民医院因深部肺结节行经皮穿刺活检的患者120例,按1∶1交错法配对分为激光引导组60例和常规方法组60例。比较两组穿刺过程中的一次性穿刺到位率、穿刺次数、CT扫描次数、操作时间、并发症发生率。以操作时间和穿刺次数为学习曲线评价指标,比较两组的学习曲线。结果与常规方法组相比,激光引导组的一次性穿刺到位率高(100%比15%)、穿刺次数少[(1.00±0.00)次比(3.15±0.68)次]、CT扫描次数少[(3.00±0.00)次比(5.15±0.68)次]、操作时间短[(19.30±2.38)min比(25.72±2.46)min],气胸率发生低(11.7%比30.0%)、出血率低(6.7%比21.7%),差异均有统计学意义(均P<0.05)。激光引导组均一次性穿刺到位,从第6例开始操作时间明显缩短并稳定,常规方法组从第20例开始操作时间和穿刺次数逐渐下降并稳定。结论双极激光定位导航仪在深部肺结节行经皮穿刺活检中一次性穿刺成功率高,稳定性高,并发症少,学习曲线低易于掌握,有较高的临床应用价值。

Objective To evaluate the effect of bipolar laser localization navigator in percutaneous biopsy of deep pulmonary nodules.Methods A total of 120 patients with deep lung nodules,who received percutaneous puncture biopsy at the Liyang Municipal People's Hospital of China between January 2020 and August 2022,were collected.By using 1:1 pairing method,the patients were divided into laser-guidance group(n=60)and conventional method group(n=60).The success rate of single puncture,the number of puncturing,the number of CT scanning,the time spent for procedure,and the incidence of complications were compared between the two groups.Taking the the time spent for procedure and the number of puncturing as the evaluation indexes,the learning curves were compared between the two groups.Results Compared with the conventional method group,in the laser-guidance group the success rate of single puncture was higher(100%vs 15%),the number of puncturing was less((1.00±0.00)times vs(3.15±0.68)times),the number of CT scanning was less((3.00±0.00)times vs(5.15±0.68)times),the the time spent for procedure was shorter((19.30±2.38)min vs(25.72±2.46)min),the incidence of pneumothorax was lower(11.7%vs 30.0%),and the incidence of bleeding was lower(6.7%vs 21.7%);the differences in all the above indexes were statistically significant(all P<0.05).In the laser-guidance group the puncturing into the right place with a single puncture was achieved in all patients,and from the 6th patient receiving percutaneous biopsy the time spent for procedure became significantly shortened and stabilized,while in the conventional method group the time spent for procedure and the number of puncturing became gradually decreased and stabilized from the 20th patient receiving percutaneous biopsy.Conclusion In carrying out percutaneous puncture biopsy of deep lung nodules,the use of bipolar laser localization navigator has several advantages,such as high technical success rate,high stability,less complications,low learning curve,easy to master,etc.Therefore,it has a high clinical application value.