CT引导术前定位在胸腔镜切除孤立性亚实性结节的随机对照研究

doi:10.3969/j.issn.1007-3205.2025.08.017

河北医科大学学报 ›› 2025, Vol. 46 ›› Issue (8): 971-976.doi: 10.3969/j.issn.1007-3205.2025.08.017

CT引导术前定位在胸腔镜切除孤立性亚实性结节的随机对照研究

河北省石家庄市人民医院胸外科，河北石家庄050027

出版日期:2025-08-25 发布日期:2025-08-29
作者简介:胡伟光(1988-)，男，河北石家庄人，河北省石家庄市人民医院主治医师，医学硕士，从事胸外科疾病诊疗研究。
基金资助:
石家庄市科技局科技支撑计划项目（201460923）

A randomized controlled study of CT-guided preoperative localization in thoracoscopic resection of solitary subsolid nodules

Department of Thoracic Surgery, Shijiazhuang People′s Hospital, Hebei Province, Shijiazhuang 050027, China

Online:2025-08-25 Published:2025-08-29

摘要/Abstract

摘要： 目的探讨CT引导弹簧圈定位在胸腔镜切除亚实性结节中的临床价值。
方法回顾性分析2022年1月—2024年10月河北省石家庄市人民医院孤立性亚实性结节（早期肺癌）患者120例，采用随机数字表法分为研究组（术前行弹簧圈定位）和对照组（直接手术），比较2组定位成功率、手术相关指标（手术时间、术中出血量、钉仓使用数量）、术后恢复情况（胸管留置时间、术后出院时间）以及心理状态变化采用焦虑自评量表(self-rating anxiety scale, SAS)和抑郁自评量表(self-rating depression scale,SDS)评估。
结果研究组定位成功率为100%，仅1例发生少量气胸；对照组1例需术中CT定位。研究组在手术时间［（94.200±25.170) min vs. (127.950±35.050) min，P＜0.05］、术后出院时间［（5.250±1.251） d vs. （7.000±1.522）d，P＜0.05］及胸管留置时间［（2.900±0.641) d vs. (3.350±0.587) d，P＜0.05］方面均显著优于对照组。2组在术中出血量、钉仓使用数量及住院费用方面比较差异无统计学意义（P＞0.05）。心理评估显示，术后研究组SAS和SDS评分均显著低于对照组（P＜0.01）。所有手术均顺利完成，无中转开胸病例，未发生弹簧圈残留或其他严重并发症。
结论 CT引导弹簧圈定位可提高手术效率，缩短术后恢复时间，改善患者心理状态，是一种安全、精准的术前定位方法，值得临床推广。

关键词: 肺肿瘤, 孤立性肺结节, 腹腔镜检查

Abstract: Objective To explore the clinical value of CT-guided spring coil localization in thoracoscopic resection of subsolid nodules.
Methods A retrospective analysis was conducted on 120 patients with solitary subsolid nodules (early stage lung cancer) in Shijiazhuang People′s Hospital from January 2022 to October 2024, who were divided into the research group (preoperative spring coil localization) and the control group (direct surgery) by using a random number table method. The success rate of localization, surgery-related indexes (duration of operation, intraoperative bleeding, number of staple cartridges used), postoperative recovery (retention time of chest tube, length of postoperative hospitalization) and changes in psychological status assessed by self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were compared between the two groups.
Results The success rate of localization in the research group was 100%, and only 1 patient experienced a small amount of pneumothorax; 1 patient in the control group required intraoperative CT localization. The research group was significantly superior to the control group in terms of duration of operation ［(94.200±25.170) min vs. (127.950±35.050) min, P＜0.05］, length of postoperative hospitalization ［(5.250±1.251) d vs. (7.000±1.522) d, P＜0.05］, and retention time of chest tube ［(2.900±0.641) d vs. (3.350±0.587) d, P＜0.05］. There was no significant difference between the two groups in terms of intraoperative bleeding, number of staple cartridges used and hospitalization expenses (P＞0.05). Psychological assessment showed that postoperative SAS and SDS scores of patients in the research group were significantly lower than those of the control group (P＜0.01). All surgeries were completed successfully, with no patient undergoing intermediate open chest and no residual spring coils or other serious complications.
Conclusion CT-guided spring coil localization can improve the efficiency of surgery, shorten the postoperative recovery time, and improve the psychological state of patients, which is a safe and precise preoperative localization method worthy of clinical popularization.

Key words: lung neoplasms, solitary pulmonary nodule, laparoscopy

胡伟光, 李喆, 刘家宝, 褚伟伟, 褚翠玲, 付卫玲. CT引导术前定位在胸腔镜切除孤立性亚实性结节的随机对照研究[J]. 河北医科大学学报, 2025, 46(8): 971-976.

HU Wei-guang, LI Zhe, LIU Jia-bao, CHU Wei-wei, CHU Cui-ling, FU Wei-ling. A randomized controlled study of CT-guided preoperative localization in thoracoscopic resection of solitary subsolid nodules[J]. Journal of Hebei Medical University, 2025, 46(8): 971-976.

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CT引导术前定位在胸腔镜切除孤立性亚实性结节的随机对照研究

A randomized controlled study of CT-guided preoperative localization in thoracoscopic resection of solitary subsolid nodules

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