医用ZT胶在肺部结节病灶胸腔镜术前定位的应用

目的探讨CT引导下肺穿刺注射医用ZT胶在肺部结节病灶胸腔镜术前定位的可行性、安全性和临床价值。方法 22例共22个肺内孤立性结节病灶,术前均行CT引导下经皮肺穿刺注射医用ZT胶定位标记,术中先行肺楔形切除术去除病灶并根据病理结果决定进一步手术方案。结果术前CT引导下经皮肺穿刺注射医用ZT胶定位成功率100%(22/22);穿刺定位后出现刺激性咳嗽10例(45.45%),无症状气胸3例(13.64%);无出血、血胸病例。术中均能准确定位后行肺楔形切除术,病理证实为原发性非小细胞肺癌16例,不典型腺瘤样增生4例,良性病变2例。均VATS下完成手术。无中转开胸病例,无术中、术后重大并发症。结论胸腔镜术前CT引导下经皮肺穿刺注射医用ZT胶定位肺部结节病灶,快速、安全、有效,特别在直径≤10 mm的肺微小结节的定位中具有较高的临床价值。

Application of medical ZT glue injection under CT-guided percutaneous for preoperative localization of vide-o-assisted thoracoscopic surgery in patients with pulmonary nodules

Objective To evaluate the feasibility,safety and clinical value of medical ZT glue injection under CT-guided percutaneous for preoperative localization of video-assisted thoracoscopic surgery in patients with pulmonary nodules. Methods 22 solitary pulmonary nodules were marked by medical ZT glue injection under CTguided percutaneous pre-operatively. They were given wedge-shape excision of lung to wipe nidus intraoperatively,and then the next operation was based on the pathological results. Results The success rate of pre-operatively CTguided percutaneous injection of medical ZT glue positioning was 100%（ 22 /22）. There were 10 cases of puncture irritating cough（ 45. 45%） and 3 cases of asymptomatic pneumothorax（ 13. 64%）,without bleeding and hemothorax cases. The wedge resection of lung lesion was performed after accurately intraoperative positioning. 16 cases of primary non-small cell lung cancer were pathologically confirmed,4 cases of atypical adenomatous hyperplasia,and 2 cases of nonmalignant disease. There was no conversion to thoracotomy patients and no VATS postoperative major complications. Conclusion The medical ZT glue injection under CT-guided percutaneous for preoperative localization of video-assisted thoracoscopic surgery is fast,safe and effective in the treatment of patients with pulmonary nodules,particularly in the lungs diameter ≤10 mm tiny nodules.