摘要
目的:总结CT引导下穿刺注射亚甲蓝定位在胸腔镜治疗肺部小结节的经验和方法。方法:回顾性分析2012年1月至2016年5月我院收治的47例患者的50枚肺部结节实行术前CT引导下穿刺注射亚甲蓝0.5 m L定位,随后在手术室行胸腔镜下肺楔形切除术或肺段切除术患者的临床资料。统计穿刺次数、定位时间、术后并发症、中转开胸率等。结果:46枚结节成功定位,4枚结节定位失败;平均穿刺次数为1.87±0.54次。定位一枚结节所需时间平均为19.4±3.8 min。无中转开放手术。定位后并发症包括:严重胸痛8例;气胸9例,1例行胸腔闭式引流术;少量血胸3例。术后病理结果:原位腺癌6枚,微浸润性腺癌9枚,浸润性腺癌17枚,不典型腺瘤样增生8枚,甲状腺癌转移瘤1枚,良性病变8枚;1例患者未找到结节,无病理结果。结论:CT引导下穿刺注射亚甲蓝定位技术安全方便,能够显著提高胸腔镜下肺部小结节手术切除的成功率。
Objective： To summarize the experiences and methods of CT guided preoperative localization with percutaneous injection of methylene blue in the treatment of small pulmonary nodules. Methods： The clinical data of 47 patients with 50 combined with small pulmonary nodules underwent CT guided localization with percutaneous injection of methylene blue （0.5 mL） before wedge-shape excision of lung with or segmentectomy with video-assisted thoracoscopic surgery from January 2012 to May 2016 were retrospectively analyzed. The small pulmonary nodules, and tallied puncture times, positioning time, postoperative complications, the rate conversion to openchest were analyzed. Results： The forty-six pulmonary nodules were localized under the CT guided with methylene blue. We tallied the number of puncture （1.87± 0.54）, and the time of localized （19.4±3.8 min）. Every case underwent the treatment of small pulmonary nodules without conversion to open chest. There were complications of preoperative localization including 8 cases with severe chest pain, 9 cases with pneumothorax and one of them underwent closed drainage of thoracic cavity, 3 cases with small amount of hemothorax. The pathological of 50 small pulmonary nodules after operation including 6 cases of adenocarcinoma in situ, 9 cases of micro invasive adenocarcinoma, 17 cases of adenocarcinoma infiltrating, 8 cases of atypical adenomatous hyperplasia, 1 metastatic neoplasms of cancerous goiters, 8 cases of benign tumour. One case had no pathological results. Conclusions： CT guided preoperative localization with percutaneous injection of methylene blue which was a understandability, secure and convenient method which could improve the rate of exairesis small pulmonary nodules with video-assisted thoracoscopic.
出处
《现代生物医学进展》
CAS
2016年第34期6721-6723,6720,共4页
Progress in Modern Biomedicine
基金
湖北省教育厅指导项目(B2016137)
十堰市科技局引导性项目(16Y67)
关键词
亚甲蓝
胸腔镜
肺部小结节
Methylene blue
Thoracoscope
Small pulmonary nodule
