CT引导下带钩金属丝在肺磨玻璃结节术前定位中的应用

Application of CT-guided hook wires in preoperative localization of pulmonary ground-glass nodules

摘要

目的：探讨CT引导下带钩金属丝在肺磨玻璃结节术前定位中的应用效果。方法：110例肺磨玻璃结节患者均接受CT引导下带钩金属丝术前定位，记录定位成功率及定位时间、并发症发生情况，分析影响CT引导下带钩金属丝肺磨玻璃结节术前定位并发症的危险因素。结果：术前结节定位成功106枚（96.36%），良性结节13例（11.82%），恶性结节97例（88.18%），29例（26.36%）患者发生术前定位并发症，定位后刺激性咳嗽18例、肺内出血7例、气胸4例。根据患者术前定位后并发症发生情况分为发生组29例和未发生组81例，两组患者的定位时间、定位体位、“危险期”时间存在显著差异（P<0.05）。经多因素Logistic回归分析，定位时间、“危险期”时间是影响CT引导下带钩金属丝肺磨玻璃结节术前定位并发症的危险因素（P<0.05）。结论：CT引导下带钩金属丝在肺磨玻璃结节术前定位中的成功率较高，但仍存在一定的并发症风险，临床需加强对定位时间及“危险期”时间的把控。

Abstract

Objective To explore the application effect of CT-guided hook wires in preoperative localization of pulmonary ground-glass nodules. Methods A total of 110 patients with pulmonary ground-glass nodules underwent preoperative localization with CT-guided hook wires. The success rate, localization time, and incidence of complications were recorded. The influencing factors for complications during the preoperative localization of pulmonary ground-glass nodules were analyzed. Results Successful preoperative nodule localization was achieved for 106 nodules (96.36%). There were 13 cases (11.82%) of benign nodules, and 97 cases (88.18%) of malignant nodules. Complications associated with preoperative localization occurred in 29 cases (26.36%), including 18 with irritative cough, 7 with intrapulmonary hemorrhage, and 4 with pneumothorax. According to the occurrence of complications after preoperative localization, patients were divided into a complication group (n=29) and a non-complication group (n=81). Significant differences were observed in localization time, localization position, and "risk period" duration between the two groups (P<0.05). Multivariate Logistic regression analysis identified localization time and "risk period" duration as risk factors for complications in patients with pulmonary ground-glass nodules after preoperative localization with CT-guided hook wires (P<0.05). Conclusion CT-guided hook wire preoperative localization achieves a relatively high success rate for pulmonary ground-glass nodules, but there is still a certain risk of complications. Clinically, it is necessary to strictly control localization time and "risk period" duration.

关键词

肺磨玻璃结节 / CT引导 / 带钩金属丝定位 / 并发症 / 危险因素

Key words

pulmonary ground-glass nodule / CT guidance / hook-wire localization / complication / risk factor

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基金资助

广西壮族自治区卫生健康科研课题(ZA20230168)