耳脑胶联合美蓝在胸腔镜诊治肺部小阴影中的应用

The application of ear-brain glue united with methylene blue in the diagnosis and treatment of small shadow in the lung throughthoracoscope

目的探讨耳脑胶联合美蓝在胸腔镜诊治肺部周围型小阴影中的应用价值。方法回顾性分析四川省人民医院2012年12月至2013年7月收治的8例肺部周围型小阴影病人的临床资料,所有病人均于术前1 h在CT室进行定位。于CT引导下行经皮肺穿刺,在肺部小阴影内注入美蓝,并在阴影外周注入医用耳脑胶作为硬化示踪剂进行定位。术中通过阴影处肺表面硬度和(或)颜色进行定位,必要时通过手指扪诊定位,术中均行肺叶楔形切除,送冰冻检查。结果本组8例病人术前均成功行肺穿刺注入耳脑胶及美蓝,术中均顺利定位阴影。无病人出现刺激性咳嗽、气胸、血胸及严重胸膜反应等与本法相关的并发症。结论耳脑胶联合美蓝在肺部小阴影的诊治中具有定位准确、安全、方便、简单易行等优点,尤其适用于胸腔镜微创手术,值得临床推广。

Objective To explore the value and application ofear-brain glueunited with methylene blue in diagnosisand treatment of small shadow in the peripheral lung throughthoracoscope.MethodsWe conducted a retrospectiveanalysis of clinical data of 8 consecutive cases of small shadowsin the peripheral lungs from December 2012 to July 2013 in our hospital.All patients underwent lung punctures guided by computed tomography(CT) for localizations in CT room1 h before surgery. The centers of all small shadowsof lungs were injected withmethylene blue. The peripheral areas ofshadows were injected with ear-brain glue, which acted as tracers for soil materialsfor localizations during the operation.The locations during operations relied on hardness and(or) color in the surface of shadows, also by finger palpations ifnecessary.All patients were performedwithwedge resectionsof lungsthrough thoracoscopic. All the shadows wereconducted with frozen biopsy.ResultsAll caseswere injectedwith ear-brain glue united with methylene blue thoughlung puncture before operation, and all the shadows were located successfully during surgery. No complications thatrelated to this methodsoccurred, such as irritating cough, pneumothorax, hemothorax, and serious pleural reaction and soon.ConclusionThe application of ear-brain glue united with methylene blue in the diagnosis and treatment ofperipheral small shadows of lungs has many advantages, such as accurate, safe, convenient, simple and feasible traits, etal. It is especially suitable for video-assisted thoracoscope surgery, worth clinical promotion.