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目的探讨肺小结节胸腔镜切除术前CT引导下带钩金属导丝锚定操作方法及其临床应用价值。方法对28例恶性肿瘤患者共30枚肺小结节行CT引导下带钩金属导丝锚定辅助胸腔镜切除,评估结节定位的成功率、手术时间、并发症,分析其对患者肿瘤分期及疗效评价的影响。结果术前CT引导下带钩金属导丝定位平均手术时间为(15.0±3.2)min。28例患者(共30枚)肺小结节中,1例(1枚)患者术中见定位针脱落,行肺叶切除;另27例(29枚)结节均准确定位并行楔形肺切除。定位术后7例(7/28,25.00%)患者发生少量气胸,针道周围少量出血8例(8/27,29.63%),其中3例(3/28,10.71%)患者同时出现少量气胸和针道周围少量出血。术后病理证实15例(15/28,53.57%)肿瘤复发转移,1例(1/28,3.57%)患者为第二原发癌,12例(12/28,42.86%)患者因确诊为肺内良性结节确定肿瘤分期不变或疗效稳定。结论肺小结节胸腔镜切除术前CT引导下带钩金属导丝锚定操作便捷,成功率高,并发症少,对患者肿瘤准确分期及疗效评价有重要意义。
Objective To investigate the method of anchoring operation of hooked metal wire under CT-guided thoracoscopic resection of pulmonary nodules and its clinical value. Methods A total of 30 pulmonary nodules from 28 patients with malignant tumor underwent CT-guided assisted guided thoracoscopic resection guided by CT. The success rate, operation time and complication of nodule localization were evaluated. And the effect of evaluation. Results The mean operative time of preoperative CT guided hooked metal wire was (15.0 ± 3.2) min. In 28 patients (30 in total), 1 patient (1 patient) was found to have missed the positioning needle in the operation and lobectomy. The other 27 patients (29) were correctly positioned for wedge-shaped lung resection. A small amount of pneumothorax occurred in 7 patients (7 / 28,25.00%) after positioning. There were 8 cases (8 / 27,29.63%) of small bleeding around the needle track. A small amount of pneumothorax was found in 3 cases (3 / 28,10.71% And a small amount of bleeding around the needle path. Fifteen patients (15/28, 53.57%) had recurrence and metastasis after operation, 1 patient (1 / 28,3.57%) had second primary cancer, and 12 patients (12/28, 42.86% Pulmonary benign nodules to determine the same stage or stable tumor efficacy. Conclusions The small nodule with thoracoscopic resection of thoracoscopic surgery guided by hooked metal wire has the advantages of convenient operation, high success rate and few complications, which is of great significance for the accurate staging of tumor and evaluation of the curative effect.