邱文 何汉 梁富豪

摘要：目的：CT引导下注射医用胶标记肺小结节术前定位的价值。方法：将本院2019年9月-2021年2月收治的46例肺小结节患者作为研究对象。根据患者入院时间随机将患者分为医用胶组、亚甲蓝组两组，每组各23例。比较两组患者在CT引导下切除病变及穿刺定位的使用时间、手术定位有效率及并发症总发生率。结果：两组患者穿刺定位用时无差异（P>0.05）;医用胶组患者切除病变用时小于亚甲蓝组（P<0.05）。医用胶组患者定位有效率（100.00%）高于亚甲蓝组（73.91%），P<0.05。医用胶组患者的刺激性干咳、无症状气胸、少量出血并发症发生率无统计学意义（P>0.05）;医用胶组并发症总发生率（26.09%）小于亚甲蓝组（39.13%），但差异无统计学意义（P>0.05）。结论： CT引导下注射医用胶标记肺小结节术前定位成功准确率高，利于缩短病变切除手术时间，降低并发症发生率，临床意义重大。

关键词：CT;注射医用胶;肺小结节;术前;定位;价值

中图分类号：R445.1;R563文献标识码：BDOI：10？郾3969/j.issn.1001-0270.2021.03.02

Abstract： Objective： To evaluate the value of CT guided injection of medical glue for preoperative localization of small pulmonary nodules. Methods： 46 patients with pulmonary nodules in our hospital from September 2019 to February 2021 were selected as the research objects. According to the admission time， the patients were randomly divided into medical glue group and methylene blue group， 23 cases in each group. The use time of CT guided resection and puncture positioning， the effective rate of surgical positioning and the total incidence of complications were compared between the two groups. Results： There was no difference in puncture positioning time between the two groups， （P>0.05）; medical glue group patients with lesion resection time was less than methylene blue group， （P<0.05）. The effective rate of positioning in medical glue group （100.00%） was higher than that in methylene blue group （73.91%） （P<0.05）. The incidence of irritative dry cough， asymptomatic pneumothorax and a small amount of bleeding complications in the medical glue group was not statistically significant（P>0.05）; the total incidence of complications in the medical glue group （26.09%） was lower than that in the methylene blue group （39.13%）， But the difference is not statistically significant（P>0.05）. Conclusion： CT guided injection of medical glue to mark small pulmonary nodules has high success rate and accuracy， which can shorten the operation time and reduce the incidence of complications.

Key words： CT; injection of medical glue; pulmonary nodules; preoperative; localization; value

近年來，随着医疗技术的飞速发展及人们健康意识的加强，肺部小结节在临床上发现率逐步增高[1]。病理诊断依旧是肺小结节的临床诊断金标准。倘若可以通过微创或无创方法对病变性质做出准确判断且达到治疗的效果，将有利于减少对患者身心健康的伤害[2]。目前，为保证肺小结节手术的顺利进行，需要对患者病灶进行准确定位。CT引导下注射亚甲蓝、医用胶、术中超声等方法均可以定位肺小结节[3]。通常情况下，定位标志物不会因为呼吸运动而引起位移[4]。注射医用胶标记肺小结节定位法，简便易行，具有较低的穿刺后气胸及出血风险，已在临床上广泛应用。本研究以我院2019年9月-2020年2月收治的46例肺小结节患者为研究对象，进一步探究该定位法的临床诊断价值。具体报道……