本文選題：肺結(jié)節(jié) + 電視輔助胸腔鏡手術(shù)��； 參考：《中國醫(yī)學影像技術(shù)》2015年04期

【摘要】：目的探討肺小結(jié)節(jié)胸腔鏡切除術(shù)前CT引導下帶鉤金屬導絲錨定操作方法及其臨床應(yīng)用價值。方法對28例惡性腫瘤患者共30枚肺小結(jié)節(jié)行CT引導下帶鉤金屬導絲錨定輔助胸腔鏡切除,評估結(jié)節(jié)定位的成功率、手術(shù)時間、并發(fā)癥,分析其對患者腫瘤分期及療效評價的影響。結(jié)果術(shù)前CT引導下帶鉤金屬導絲定位平均手術(shù)時間為(15.0±3.2)min。28例患者(共30枚)肺小結(jié)節(jié)中,1例(1枚)患者術(shù)中見定位針脫落,行肺葉切除;另27例(29枚)結(jié)節(jié)均準確定位并行楔形肺切除。定位術(shù)后7例(7/28,25.00%)患者發(fā)生少量氣胸,針道周圍少量出血8例(8/27,29.63%),其中3例(3/28,10.71%)患者同時出現(xiàn)少量氣胸和針道周圍少量出血。術(shù)后病理證實15例(15/28,53.57%)腫瘤復發(fā)轉(zhuǎn)移,1例(1/28,3.57%)患者為第二原發(fā)癌,12例(12/28,42.86%)患者因確診為肺內(nèi)良性結(jié)節(jié)確定腫瘤分期不變或療效穩(wěn)定。結(jié)論肺小結(jié)節(jié)胸腔鏡切除術(shù)前CT引導下帶鉤金屬導絲錨定操作便捷,成功率高,并發(fā)癥少,對患者腫瘤準確分期及療效評價有重要意義。
[Abstract]:Objective to investigate the operative method and clinical application of metal guide wire anchoring under CT guidance before thoracoscopic resection of small pulmonary nodules. Methods A total of 30 pulmonary nodules in 28 patients with malignant tumor were treated with CT-guided assisted thoracoscopic resection with metal guide wire anchor. The success rate, operative time and complications of nodule localization were evaluated. To analyze its effect on tumor staging and curative effect evaluation. Results the mean operative time of preoperative CT guided metal guide wire localization was 15.0 鹵3.2)min.28 (30 pulmonary nodules), 1 case of small pulmonary nodules (1 case) was found to be exfoliated during operation, and the lobectomy was performed. In the other 27 cases, 29 nodules were accurately located and wedge pneumonectomy was performed. There were 7 cases of pneumothorax and 8 cases of hemorrhage around the needle path in 7 cases (7 / 28 25. 00%). Among them, 3 cases (3 / 28 / 10. 71) had a small amount of pneumothorax and a small amount of bleeding around the needle tract at the same time. Postoperative pathology confirmed that 15 cases (15 / 2853.57) tumor recurrence and metastasis (1 / 28 / 283.57) patients were second primary carcinoma 12 / 12 / 2842.86) patients were diagnosed as benign nodules in the lung to determine that the tumor stage was unchanged or the curative effect was stable. Conclusion before thoracoscopic resection of small pulmonary nodules, the anchoring with hook metal wire under the guidance of CT is convenient, the success rate is high, and the complications are few. It is of great significance for the accurate staging and evaluation of the curative effect of the tumor.
【作者單位】： 北京大學腫瘤醫(yī)院;北京市腫瘤防治研究所醫(yī)學影像科;北京市腫瘤防治研究所胸部腫瘤外一科惡性腫瘤發(fā)病機制及轉(zhuǎn)化研究教育部重點實驗室;
【基金】：國家重點基礎(chǔ)研究發(fā)展計劃(973計劃)項目(2011CB707705) 國家自然科學基金(81371715) 北京市科學技術(shù)委員會:首都特色臨床應(yīng)用研究(Z121107001012115)
【分類號】：R730.44;R734.2

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本文編號：1787033