【摘要】 目的探讨孤立性肺结节术前三维CT引导下钩丝定位技术对胸腔镜手术的增益价值。方法收集行胸腔镜手术切除孤立性肺结节患者共92例,其中术前行三维CT引导下钩丝定位者37例,未行定位者55例。回顾性分析术前钩丝定位对胸腔镜转为开胸手术的几率、平均手术时间、平均住院时间的影响,并对其差异进行统计学分析。结果术前三维CT引导下钩丝定位成功率100.0%,定位操作时间平均(11.5±7.2)min,并发气胸及出血发生率为56.8%(21/37)。钩丝定位后胸腔镜转为开胸手术的几率为5.4%(2/37),平均手术时间为(21.7±8.0)min,平均住院时间为(9.5±3.5)天。未定位直接行胸镜手术,转为开胸手术的几率为29.1%(16/55)、平均手术时间(45.9±10.4)min,平均住院时间为(14.1±4.5)天。分别进行2检验和t检验,P<0.05,差异有统计学意义。结论术前三维CT引导下钩丝定位技术安全、准确,降低了转为开胸手术的几率,缩短了胸腔镜的手术时间和住院时间,对于孤立性肺结节胸腔镜手术具有很好的增益价值。更多还原

【Abstract】 Objective To evaluate the incremental value of three-dimensional computed tomography-guided localization with Hook-wire for solitarypulmonary nodule(SPN) before video-assisted thoracoscopic surgery(VATS).Methods From Jan 2003 to Dec 2011,92 patients underwent thoracoscopic pulmonary resection,of which 37 patients with SPN were preoperatively localized by CT-guided Hook-wire,other 55 patients without being localized using CT-guided Hook-wire.The onversion rate of open thoracotomy,average duration of operation and average hospitalization time were retrospectively compared between two groups,t-test and χ22 test were used.Results Preoperative CT-guided Hook-wire localization was successful in all patients(100.0%).The average localization time was(11.5±7.2) min.The occurrence rate of pneumothorax and hemothorax was 56.8%(21/37).In two group with and without Hook-wire localized,the conversion rate of open oracotomy,average duration of operation and average hospitalization time were 5.4%(2/37),(21.7±8.0) min,(9.5±3.5) d and 29.1%(16/55),(45.9±10.4) min,(14.1±4.5) d,respectively.There were statistically significant different between with and without Hook-wire localized groups(P<0.05).Conclusion Preoperative CT-guided Hook-wire localization is suitable,safe and effective for VATS resection of SPN.It is related to a low alteration thoracotomy rate,short operation time and hospitalization time,and it has incremental value for the VATS resection of SPN.更多还原