| 张学驰,王龙飞,石 邈,等.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[J].肿瘤学杂志,2024,30(12):1014-1022. |
| 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 |
| Application Value of Fluorescence Localization with Indocyanine Green in Single-Port Thoracoscopic Resection of Pulmonary Nodules |
| 投稿时间：2024-06-13 |
| DOI：10.11735/j.issn.1671-170X.2024.12.B006 |
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| 中文关键词: 肺结节 吲哚菁绿 单孔荧光胸腔镜 Hookwire 术前定位 |
| 英文关键词:pulmonary nodule indocyanine green single-port fluorescence thoracoscopy Hookwire preoperative localization |
| 基金项目:“中国青年医学创新研究科研课题”项目（第五期）；宁波市临床医学研究中心项目（2021L002） |
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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、围手术期相关指标等进行分析。［结果］ 两组的定位成功率、定位时间、胸膜反应、肺内出血、定位相关性血胸差异均无统计学意义（P均＞0.05）。实验组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明显低于对照组（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、术后病理结果差异均无统计学意义（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 application value of CT-guided percutaneous fluorescence localization with indocyanine green (ICG) in single-port thoracoscopic resection of pulmonary nodules. ［Methods］ The clinical data of 100 patients who underwent single-port thoracoscopic resection of pulmonary nodu-les in Department of Thoracic Surgery of the First Affiliated Hospital of Ningbo University from February 2022 to December 2023 were retrospectively analyzed. The localization of pulmonary nodules was performed before surgery， 48 cases underwent CT-guided percutaneous Hookwire localization (control group) and 52 cases underwent CT-guided percutaneous ICG localization and fluorescence thoracoscopic surgery (study group). The clinical data， localization time， localization success rate， localization complications and other perioperative indicators were compared between two groups with SPSS21.0 software. ［Results］ There was no significant difference in localization success rate， localization time， pleural reaction， intraoperative pulmonary hemorrhage and localization-related hemothorax between two groups (all P>0.05). The pain score after localization in the study 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 in the study group was lower than that in the control group (7.7% vs 31.2%， P=0.003). The incidence of cough during the operation in the study group was significantly higher than that in the control group (92.3% vs 8.3%， P<0.001). There was no significant difference in operation time， surgical procedure type， pleural adhesion， intraoperative blood loss， postoperative chest tube duration， postoperative hospital stay， and postoperative pathological results between two groups (P>0.05). ［Conclusion］ ICG localization of pulmonary nodules is simple and effective， with high success rate， long maintenance time after localization， less pain， good safety and few adverse reactions， which is especially advantageous for patients who need to locate multiple nodules and is worthy of promotion and application. |
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