胸腔镜肺小结节切除术前微弹簧圈定位的临床应用研究

目的:研究孤立性肺结节(SPN)胸腔镜术前CT引导下双弹簧圈精准标记定位的应用价值。方法:回顾分析43例SPN胸腔镜术前定位病例资料，包括双弹簧圈组22例，Hook-wire定位组21例。统计双弹簧圈定位的术中、术后并发症，衔接期时间以及作楔形切除所用时间，并将两组结果进行对比分析。结果:两组病例定位均取得成功；双弹簧圈组的气胸发生率(9.0%)，肺出血发生率(9.0%)，胸痛发生率(9.0%)均低于Hook-wire组，其中肺出血发生率与Hook-wire组比较，差异有统计学意义(P＜0.01)；衔接时间双弹簧圈组（15.38±8.32）h长于Hook-wire组（4.21±3.29）h，差异有统计学意义（P＜0.05）；作楔形切除所用时间双弹簧圈组(21.01±7.14)min与Hook-wire组(18.22±5.18)min差异无统计学意义(P＞0.05)。结论:采用双微弹簧圈进行SPN胸腔镜手术前精准标记定位安全可靠、效果良好，与Hook-wire定位比较并发症发生率更低，并可获得更长的衔接期，具有较高的应用价值。

Clinical application of microspring coil location before thoracoscopic pulmonary tuberculectomy

Objective:To study the application value of precise marking of double-spring ring under the guidance of CT in solitary pulmonary nodule (SPN) before thoracoscopy.Methods:43 cases of SPN thoracoscopic preoperative positioning were retrospectively analyzed,including 22 cases of double spring loop and 21 cases of Hook-wire location.The clinical complications,interlocking time and the time of cuneiform resection were measured,and the results of the two groups were compared.Results:Both groups of cases were successfully located.The incidence of pneumothorax (9.0%),pulmonary hemorrhage (9.0%) and chest pain (9.0%) in the double spring group were all lower than those in the Hook-wire group.The incidence of pulmonary hemorrhage was statistically significant compared with that in the Hook-wire group (P＜0.01).The length of the double-spring circle group (15.38±8.32)h and the Hook-wire group (4.21±3.29)h at the junction time was statistically significant (P＜0.05).The time used for cuneiform resection was not statistically significant in the double-spring circle group (21.01±7.14)min and the Hook-wire group (18.22±5.18)min (P＞0.05).Conclusion:The accurate marker positioning before SPN thoracoscopy is safe,reliable,and effective.Compared with Hook-wire,the incidence of complications is lower,and a longer follow-up period can be obtained,which has higher application value.