CT引导下亚甲蓝联合吲哚菁绿术前定位老年肺结节的应用研究

doi:10.3969/j.issn.1003-9198.2024.07.015

摘要/Abstract

摘要： 目的比较CT引导下Hookwire与亚甲蓝(MB)联合吲哚菁绿(ICG)术前定位老年肺结节的可行性、安全性,并分析定位过程中常见并发症的危险因素。方法回顾性分析2023年1—5月南京鼓楼医院胸腔镜手术前行肺小结节术前定位的88例老年病人的临床资料。依据术前定位方式分为Hookwire组(n=50)和MB联合ICG组(n=38),比较2组病人一般临床资料、手术相关资料、定位效果及相关并发症发生情况。采用多因素Logistic回归分析常见并发症的危险因素。结果 2组病人定位期间均未发生严重并发症及死亡。Hookwire组气胸发生率和疼痛评分(NRS)明显高于MB联合ICG组,定位时长明显短于MB联合ICG组,差异均有统计学意义(P<0.05)。Hookwire组脱钩2例,MB联合ICG组失败1例,2组定位成功率差异无统计学意义(P>0.05)。多因素Logistic回归分析显示,定位方式是气胸发生的独立危险因素(OR=17.71,95%CI:3.48～90.09,P<0.05)。结论 CT引导下Hookwire与MB联合ICG在老年术前定位肺结节中获得了良好的效果。虽然MB联合ICG定位时间略长,但病人气胸发生率很低,疼痛更轻。

关键词: 亚甲蓝, 吲哚菁绿, 术前定位, 胸腔镜手术, 老年人

Abstract: Objective To compare the feasibility and safety of Hookwire and methylene blue combined with indocyanine green (MB＆ICG)for the preoperative localization of pulmonary nodule (PN) in the elderly, and to explore the risk factors for common complications. Methods A retrospective analysis was conducted on the clinical data of 88 elderly patients who underwent preoperative localization of PN before video-assistant thoracoscopic surgery (VATS) at Nanjing Drum Tower Hospital from January to May 2023. The patients were divided into Hookwire group (n=50) and MB＆ICG group (n=38) group according to preoperative localization methods. General clinical data, operative data, localization effect and related complications of the two groups were compared. Multivariate Logistic regression was used to analyze the risk factors of common complications. Results No deaths or serious complications occurred during localization. Compared with MB＆ICG group, Hookwire group had higher incidence rate of pneumothorax, higher pain score and shorter positioning time (P<0.05). There was no significant difference in the localization success rate between the two groups (P>0.05). Multivariate Logistic regression analysis showed that location mode was an independent risk factor for pneumothorax (OR=17.708, 95%CI: 3.481-90.085, P<0.05). Conclusions Hookwire and MB ＆ICG under CT guidance had achieved good results in preoperative localization of PN in the elderly. Although the localization time of MB＆ICG was longer, the patients have a lower incidence of pneumothorax and less pain.

Key words: methylene blue, indocyanine green, preoperative localization, thoracoscopic surgery, aged

中图分类号:

R 814.42

黄仁华, 史敏科. CT引导下亚甲蓝联合吲哚菁绿术前定位老年肺结节的应用研究[J]. 实用老年医学, 2024, 38(7): 709-712.

HUANG Renhua, SHI Minke. CT-guided application of methylene blue combined with indocyanine green in preoperative localization of pulmonary nodule in the elderly[J]. Practical Geriatrics, 2024, 38(7): 709-712.

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