Objective To investigate the application value and effect of lung vascular and lesion positioning guided by Doppler ultrasound in the operation of thoracoscopic lobectomy. Methods Thirty cases of experimental pigs were randomly divided into A, B and C three groups. The group A was operated by conventional thoracoscope for upper right lobectomy, and group B was operated by thoracoscope for upper right lobectomy which guided by Doppler ultrasound cavity prober. Then, the operation time, blood loss and materials costs were compared between the two groups. The group C was used to establish the model of lung cancer and CT scanning was used to indicate the lung lesions. During operation, lesions were positioned by Doppler ultrasound and wedge resections were performed under thoracoscope. Then, the pulmonary lobectomy guided by ultrasound and mediastinal lymph nodes dissection were performed. At last, the coincidence rate of intraoperative ultrasound and CT location was analyzed statistically. Results There were significant differences in operation time between Groups A and B ( < 0.01), while no significant differences in blood loss and material costs ( >0.05) . In group C, lesion location positioning guided by ultrasound during the operation was completely consistent with guided by CT before the operation. No significant differences in the lesion diameter were observed between ultrasound and CT methods ( > 0.05) . Conclusion With the application of Doppler ultrasound, the invisible and untouchable blood vessel can become visible and can be positioned in precise to shorten the time of thoracoscopic lobectomy. In addition, the accurate positioning of tiny lesions in the lung can solve the problem of lung small lesion positioning which is difficult in the operation under thoracoscope. Therefore, it can be promoted in clinical applications in a wide range.%目的：探讨全胸腔镜肺叶切除手术中用多普勒超声引导下肺血管、病灶定位的应用价值和效果．方法将30例实验猪随机分为A、B、C 3组，A组常规胸腔镜下右上肺叶切除，B组多普勒超声腔内探头引导下行胸腔镜右上肺叶切除，比较2组的手术时间、出血量、耗材费用；C组制作肺癌模型，CT扫描提示有肺部病灶的，术中用超声定位病灶，并在胸腔镜下病灶楔形切除，再行超声引导下病肺叶切除，并行纵隔淋巴结清扫，统计术中超声与CT定位的符合率．结果 A组与B组在手术时间方面比较差异显著，有统计学意义（＜0.05）；在出血量、耗材费用方面比较差异不显著，无统计学意义（＞0.05）；C组术中超声与术前CT对于病灶位置的定位完全吻合，对于病灶直径大小的比较差异不显著，无统计学意义（＞0.05）．结论用多普勒腔内超声，将不能看到和触摸到的血管通过超声而显露提示，对血管精确定位，从而缩短胸腔镜肺叶切除手术的时间，同时可以对肺内微小病灶准确定位，解决了胸腔镜手术中肺微小病灶难以定位的问题，可以很好地应用推广于临床．
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