Objective To investigate the effect of CT guided localization of Hookwire and its influence on complications in patients with solitary pulmonary nodules undergoing video-assisted thoracoscopic surgery. Methods From January 2016 to January 2017,92 patients(97 pieces) with solitary pulmonary nodules were treated with CT guided Hookwire localization and video-assisted thoracoscopic surgery. The location effect, postoperative complica-tions and complications were analyzed. Results The complication rate of all patients was 22.83% (21/92), and the success rate of Hookwire localization was 95.65% (88/92). All 97 pulmonary nodules underwent video-assisted thoracoscopic surgery. The mean operative time was(22.4 ± 4.2) min,and the mean bleeding volume was(20.4 ± 3.8) mL. The univariate analysis showed that the distance between the nodules and the pleura, the angle of needle insertion,the history of lung diseases,the depth of the needle insertion and the time of puncture were the significant influencing factors of the complications(P<0.05). The multivariate logistic stepwise regression analysis showed that the time of puncture,the depth of needle insertion and the history of lung disease were the independent risk factors for complications (P <0.05). Conclusion CT guided Hookwire positioning under the application of preoperative solitary nodules can effectively improve the accuracy of lesion localization, lower the incidence of symptoms and complications of this method, which is worthy of widely clinical promotion.%目的 探究孤立性肺结节患者行电视胸腔镜术前实施CT引导下Hookwire定位的效果及对术后并发症的影响.方法 选取2016年1月至2017年1月收治的92例(97个)孤立性肺结节患者,术前给予CT引导下Hookwire定位并采用电视胸腔镜手术进行治疗.分析病灶定位效果、术后并发症及影响并发症因素等情况.结果 所有患者并发症发生率为22.83%(21/92),Hookwire定位成功率为95.65%(88/92).所有97个肺结节均进行电视胸腔镜手术,平均手术时间为(22.4 ± 4.2)min,平均出血量为(20.4 ± 3.8)mL.经单因素分析结果可见,结节与胸膜的距离、进针角度、肺部疾病史、进针深度及穿刺时间为导致并发症发生的显著影响因素(P<0.05).经多因素Logistic逐步回归模型分析显示穿刺时间、进针深度及肺部疾病史为并发症发生的独立危险因素(P<0.05).结论 CT引导下的Hookwire定位应用于术前孤立性结节中可有效提高病灶定位的准确率,且此方法并发症的发生率较低、症状轻,能够在术中一并处理,值得临床推广.
展开▼
