CT引导穿刺亚厘米肺小结节放置手工钢丝钩定位在胸腔镜手术中应用.doc

CT引导穿刺亚厘米肺小结节放置手工钢丝钩定位在胸腔镜手术中应用 　　[摘要] 目的 探讨CT引导下穿刺亚厘米肺小结节放置手工钢丝钩定位在胸腔镜手术中的价值。 方法 选取本院2013年5月～2015年8月的46例胸腔镜手术患者作为研究对象，共46个亚厘米肺小结节。根据是否进行手工钢丝钩定位将入选患者分为A组（同意并签署同意书）和B组（不同意且未签署同意书）。比较两组的平均手术时间、转为开胸手术发生率、平均住院时间。 结果 A组的开胸手术发生率显著低于B组，差异有统计学意义（P<0.01）。A组的平均手术时间、平均住院时间显著短于B组，差异有统计学意义（P<0.01）。 结论 CT引导下穿刺亚厘米肺小结节放置手工钢丝钩定位能够明显降低术中转开胸手术发生率，缩短胸腔镜手术时间、平均住院时间，对亚厘米肺小结节的诊治具有很好的临床价值。 　　[关键词] CT引导下定位；肺小结节；胸腔镜手术；钢丝钩 　　[中图分类号] R445.3 [文献标识码] A [文章编号] 1674-4721（2016）01（c）-0071-04 　　[Abstract] Objective To explore the value of CT-guided localization with a manual Hook-wire for sub-centimeter small pulmonary nodule punctured in the video-assisted thoracic surgery. Methods 46 patients with video-assisted thoracic surgery in our hospital from May 2013 to August 2015 were selected as the research group，there were altogether 46 sub centimeter small pulmonary nodules.All patients were divided into group A （agreed and signed the agreement） and group B （disagreed and did not sign the agreement） according to whether or not localization with manual Hook-wire.The average operation time，the incidence rate of open chest surgery，the average length of stay in the two groups was compared respectively. Resullts The incidence rate of open chest surgery in group A was lower than that in group B，with significant difference （P<0.01）.The average operation time and the average length of stay in group A was shorter than that in group B，with significant difference （P<0.01）. Conclusion CT-guided localization with a manual Hook-wire for sub-centimeter small pulmonary nodule punctured can significantly reduce the incidence rate of conversion to open chest surgery，shorten the operation time and the average length of stay in the hospital，which has a very good clinical value in the diagnosis and treatment of the sub-centimeter small pulmonary nodule. 　　[Key words] CT-guided localization；Small pulmonary nodule；Video-assisted thoracic surgery；Hook-wire 　　随着螺旋CT系统在我国各级医疗卫生单位胸部检查中的广泛应用，难以定性的肺小结节越来越多地被发现[1]。对肺楔形切除术的肺