本文選題：肺小結(jié)節(jié) + 微彈簧圈定位��； 參考：《中國(guó)微創(chuàng)外科雜志》2017年03期

【摘要】：目的探討術(shù)前CT引導(dǎo)下微彈簧圈定位在胸腔鏡孤立性肺小結(jié)節(jié)切除術(shù)中的應(yīng)用價(jià)值。方法 2014年5月~2016年4月,對(duì)21例單發(fā)肺部小結(jié)節(jié)病灶經(jīng)術(shù)前定位后行胸腔鏡手術(shù)切除。結(jié)節(jié)直徑7~21(10.3±8.0)mm,距離臟層胸膜深度5~23(10.2±4.3)mm。術(shù)前1日在CT引導(dǎo)下行"拖尾法"微彈簧圈術(shù)前定位,胸腔鏡下行病灶楔形切除術(shù),送冰凍病理,如為惡性繼續(xù)行胸腔鏡下肺葉切除加縱隔淋巴結(jié)清掃術(shù)。結(jié)果全組21例肺小結(jié)節(jié)均成功經(jīng)皮肺穿刺置入微彈簧圈。定位并發(fā)癥為無(wú)癥狀氣胸3例,均無(wú)需處理。胸腔鏡術(shù)中發(fā)現(xiàn)微彈簧圈脫位3例,定位成功率85.7%(18/21)。21例均行胸腔鏡手術(shù)切除。病理確診原位癌5例,腺癌11例,非典型腺瘤樣增生1例,炎癥2例,炎性假瘤1例,肺內(nèi)轉(zhuǎn)移瘤1例。結(jié)論 CT引導(dǎo)下微彈簧圈定位用于肺內(nèi)小結(jié)節(jié)術(shù)前定位是一種簡(jiǎn)單、直觀、有效、精確的方法,值得推廣。
[Abstract]:Objective to evaluate the value of preoperative CT guided microcoils localization in thoracoscopic solitary pulmonary nodule resection.Methods from May 2014 to April 2016, 21 patients with single pulmonary nodules underwent thoracoscopic resection after preoperative localization.The diameter of the nodules was 7: 21 鹵8. 3 鹵8. 0 mm, and the depth of the visceral pleura was 5 23. 2 鹵4. 3 mm..On the 1st day before operation, the "trailing method" microcoils were located before operation under the guidance of CT, and the focus wedge resection was performed under thoracoscopy, and the frozen pathology was sent, such as continuing thoracoscopic lobectomy and mediastinal lymph node dissection for malignant cases.Results all 21 cases of pulmonary nodules were successfully implanted with microcoils through pulmonary puncture.The localization complication was asymptomatic pneumothorax in 3 cases.Three cases of dislocation of microcoils were found during thoracoscopic operation, and the success rate of localization was 85.7% 21 cases. All cases underwent thoracoscopic resection.Pathological diagnosis included 5 cases of carcinoma in situ, 11 cases of adenocarcinoma, 1 case of atypical adenomatous hyperplasia, 2 cases of inflammation, 1 case of inflammatory pseudotumor and 1 case of intrapulmonary metastasis.Conclusion CT guided microcoil localization is a simple, intuitive, effective and accurate method for preoperative localization of small pulmonary nodules, and it is worth popularizing.
【作者單位】： 福建醫(yī)科大學(xué)教學(xué)醫(yī)院莆田市第一醫(yī)院胸外科;北京大學(xué)人民醫(yī)院胸外科胸部微創(chuàng)中心;
【分類(lèi)號(hào)】：R655.3

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