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| 吲哚菁绿定位法在单孔荧光胸腔镜肺结节手术中的临床应用价值与分析 |
| The Clinical Application Value and Analysis of Indocyanine Green Localization in Single-Port Fluorescence Thoracoscopic Pulmonary Nodule Resection |
| 投稿时间：2024-06-13 修订日期：2024-09-09 |
| DOI： |
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| 中文关键词: 肺结节 单孔荧光胸腔镜 吲哚菁绿 Hookwire 术前定位 |
| 英文关键词:pulmonary nodule single-port fluorescence thoracoscopy indocyanine green Hookwire preoperative localization |
| 基金项目:1.中国青年创业就业基金会2.宁波市胸部恶性肿瘤临床医学研究中心 |
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| 中文摘要: |
| 摘要：[目的] 探讨术前CT引导下经皮穿刺吲哚菁绿（indocyanine green, ICG）定位法在单孔荧光胸腔镜下肺结节切除术中的临床应用价值。[方法] 回顾性收集与分析2022年2月至2023年12月于宁波大学附属第一医院胸外科同一医疗组行单孔胸腔镜下肺结节切除术共100例患者的临床资料。所有患者术前均行肺结节定位，按照定位方法不同分成对照组48例和实验组52例，对照组采用传统CT引导下经皮穿刺Hookwire定位法，实验组采用CT引导下经皮穿刺ICG定位法，并在荧光胸腔镜下完成手术。应用SPSS 21.0软件对两组间的临床资料、定位时间、定位成功率、定位并发症、围术期相关指标等进行统计学差异比较分析，P＜0.05为差异有统计学意义。[结果] 两组间的定位成功率、定位时间、胸膜反应、肺内出血、定位相关性血胸均无统计学差异（P均＞0.05）。实验组的患者定位后疼痛评分明显小于对照组[2（2,2） vs. 4(4,5),P＜0.001]，且定位后气胸发生率低于对照组（7.7% vs. 31.2%, P=0.003）；实验组患者操作过程中咳嗽发生率明显高于对照组（92.3% vs. 8.3%, P＜0.001）。两组患者的手术时间、手术方式、胸膜粘连、术中出血量、术后胸管留置时间、术后住院时间、术后病理结果等均无统计学差异（P均＞0.05）。[结论] 肺结节ICG定位法操作简单有效，成功率高，定位后维持时间长，疼痛轻且安全性良好，不良反应较少，尤其对于需要定位多枚结节的患者更具优势，值得在单孔荧光胸腔镜辅助肺结节切除术中推广应用。 |
| 英文摘要: |
| Abstract:[Objective]: To explore the clinical application value of preoperative CT-guided percutaneous indocyanine green (ICG) localization in single-port fluorescence thoracoscopic resection of pulmonary nodules.[Methods]: The clinical data of 100 patients who underwent single-port thoracoscopic resection of pulmonary nodule in the same medical group of the Department of Thoracic Surgery of the First Affiliated Hospital of Ningbo University from February 2022 to December 2023 were retrospectively collected and analyzed. All patients underwent pulmonary nodal localization before surgery, and were divided into control group(48 cases) and experimental group(52 cases) according to different localization methods. The control group was treated with traditional CT-guided percutaneous Hookwire localization method, while the experimental group was treated with CT-guided percutaneous ICG localization method, and the surgery was completed under fluorescence thoracoscopy. SPSS21.0 software was used to statistically compare the clinical data, localization time, localization success rate，localization complications and perioperative related indicators between the two groups,and P<0.05 indicates statistical significance.[Results]: There were no statistically significant differences in localization success rate, localization time, pleural reaction, intraoperative pulmonary hemorrhage,and localization related hemothorax between the two groups(P>0.05). The pain score after localization in the experimental group was significantly lower than that in the control group[2(2,2) vs. 4(4,5), P<0.001], and the incidence of pneumothorax after localization was lower in the experimental group than in the control group(7.7% vs. 31.2%, P=0.003). The incidence of cough during the operation was significantly higher in the experimental group than in the control group(92.3% vs. 8.3%, P<0.001). There were no statistically significant differences in operation time, Surgical procedure type, pleural adhesion, intraoperative blood loss, postoperative chest tube duration, postoperative hospital stay, and postoperative pathological results between the two groups(P >0.05).[Conclusion]:ICG localization of pulmonary nodules is simple and effective, with high success rate, long maintenance time after localization, light pain, good safety and few adverse reactions,It is especially advantageous for patients who need to locate multiple nodules, and is worthy of promotion and application in single-port fluorescence thoracoscopic assisted resection of pulmonary nodules. |
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