黄亚男,赵振华,王挺,卢增新,宋坤,王彬,喻光懋,王诚,胡红杰.对比医用胶与Hook-wire在肺小结节胸腔镜下肺组织切除术前定位中的应用[J].中国介入影像与治疗学,2019,16(2):77-82
对比医用胶与Hook-wire在肺小结节胸腔镜下肺组织切除术前定位中的应用
Comparison between medical adhesive and Hook-wire inpre-thoracoscopy localization of small pulmonary nodules
投稿时间:2018-05-04  修订日期:2018-12-23
DOI:10.13929/j.1672-8475.201805002
中文关键词:  医用胶  定位  胸腔镜检查    结节
英文关键词:medical adhesive  localization  thoracoscopy  lung  nodule
基金项目:浙江省自然科学基金(LY16H180006)、浙江省医药卫生一般研究计划课题(2018KY170)、浙江省医药卫生科技项目(2018243718)、绍兴市科技局公益性技术应用项目(2017B70040)。
作者单位E-mail
黄亚男 绍兴市人民医院放射科, 浙江 绍兴 312000  
赵振华 绍兴市人民医院放射科, 浙江 绍兴 312000 zhao2075@163.com 
王挺 绍兴市人民医院放射科, 浙江 绍兴 312000  
卢增新 绍兴市人民医院放射科, 浙江 绍兴 312000  
宋坤 绍兴市人民医院放射科, 浙江 绍兴 312000  
王彬 绍兴市人民医院心胸外科, 浙江 绍兴 312000  
喻光懋 绍兴市人民医院心胸外科, 浙江 绍兴 312000  
王诚 绍兴市人民医院病理科, 浙江 绍兴 312000  
胡红杰 浙江大学医学院附属邵逸夫医院放射科, 浙江 杭州 310000  
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中文摘要:
      目的 对比医用胶与Hook-wire在肺小结节(最大径≤ 30 mm)胸腔镜下肺组织切除术前定位中的应用价值。方法 回顾性分析107例接受胸腔镜下肺楔形切除、肺段或肺叶切除术的肺小结节患者的资料。按术前定位方法分为医用胶组(88例,共90个结节)及Hook-wire组(19例,共19个结节),比较2组病灶位置、结节大小、结节与胸膜的距离、结节良恶性、胸腔镜手术方式及并发症(包括气胸、肺出血、局部疼痛、咳嗽)的差异,并对并发症的相关危险因素进行二元Logistic回归分析。结果 2组病灶位置、结节大小、结节与胸膜的距离、结节良恶性及胸腔镜手术方式差异均无统计学意义(P均>0.05),术前定位成功率均为100%。医用胶组总体并发症发生率及肺出血发生率均明显低于Hook-wire组(P均<0.01)。定位方法为总体并发症、肺出血、局部疼痛的独立危险因子,结节到胸膜的距离为肺出血的独立危险因子。结论 医用胶可用于肺小结节胸腔镜下肺组织切除术前定位,且相对于Hook-wire定位并发症发生率更低。
英文摘要:
      Objective To compare the application value between medical adhesive and Hook-wire in pre-thoracoscopy localization of small pulmonary nodules (≤ 30 mm). Methods Data of 107 patients with small pulmonary nodules who underwent thoracoscopic wedge resection, segmental or lobectomy were retrospectively analyzed. The patients were divided into medical adhesive group (88 cases with 90 nodules) and Hook-wire group (19 cases with 19 nodules) according to pre-thoracoscopy localization method. The location of lesion, nodule size, distance between nodule and pleura, nature of nodule(benign or malignant), surgery method and complications (including pneumothorax, pulmonary hemorrhage, pain and cough) were compared between the two groups. Binary Logistic regression analysis was performed to determine the complications' related risk factors. Results There was no significant difference of the location of lesion, nodules size, distance between nodule and pleura, nature of nodule nor the method of thoracoscopic surgery between the two groups (all P>0.05). The pre-thoracoscopy localization success rate of both two groups were 100%. The overall complication rate and the incidence of pulmonary hemorrhage in medical adhesive group were significantly lower than those in Hook-wire group (both P<0.01). The localization method was an independent risk factor for complications after pre-thoracoscopy localization, pulmonary hemorrhage and chest pain, while the distance from the nodule to pleura was an independent risk factor for pulmonary hemorrhage. Conclusion Medical adhesive can be used for pre-thoracoscopy localization of small pulmonary nodule with lower complication rate compared with Hook-wire.
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