[1]黄晓媚 杨清杰*① 孙晓雁① 胡蒙 包传恩 郭明.自主研发的三维激光引导装置在经皮肺小结节穿刺中的应用[J].中国微创外科杂志,2019,01(11):1027-1031.
　Huang Xiaomei*,Yang Qingjie,Sun Xiaoyan,et al.Application of Selfdeveloped 3D Laser Guidance Device in Percutaneous Puncture of Pulmonary Nodules[J].Chinese Journal of Minimally Invasive Surgery,2019,01(11):1027-1031.
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自主研发的三维激光引导装置在经皮肺小结节穿刺中的应用()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2019年11期
页码:
1027-1031
栏目:
新技术新方法
出版日期:
2019-11-25

文章信息/Info

Title:
Application of Selfdeveloped 3D Laser Guidance Device in Percutaneous Puncture of Pulmonary Nodules
作者:
黄晓媚 杨清杰*① 孙晓雁① 胡蒙 包传恩 郭明
（中国人民解放军陆军第七十三集团军医院胸外科，厦门361003）
Author(s):
Huang Xiaomei*;  Yang Qingjie;  Sun Xiaoyan;  et al.
*Department of Thoracic Surgery, Hospital of the 73rd Army Group of PLA, Xiamen 361003, China
关键词:
激光引导; 经皮肺穿刺; 肺结节
Keywords:
Laser guidance; Percutaneous lung puncture; Pulmonary nodule
文献标志码:
B
摘要:
目的探讨自主研发的三维激光引导装置在CT定位下经皮肺小结节穿刺活检术中的应用价值。 方法三维激光引导装置由不锈钢的双弓形支架、激光角度仪、滑块和引导支架组成。激光角度仪和引导支架固定在滑块上，激光角度仪可旋转，变换角度（与水平之间的角度），并在前端投射出相应角度的十字激光，即十字激光焦点的光线与地面之间的角度等于角度仪上显示的角度。采用配对对比研究，将2018年1~12月70例肺小结节分为观察组（三维激光引导下穿刺）和对照组（常规手法穿刺）。比较2组一次穿刺达预定位置率、穿刺过程中CT扫描次数、穿刺操作时间和并发症发生率。结果与对照组相比，观察组一次穿刺达预定位置率高［94.3%(33/35) vs. 45.7%(16/35)， χ2=19.660，P=0.000］，穿刺过程中CT扫描次数少［(3.1±0.2)次vs.(4.1±1.3)次，t=-4.731，P=0.000］，穿刺操作时间短［(19.9±4.1)min vs. (283±98)min，t=-4.684，P=0.000］，并发症发生率低但无统计学意义［8.6%（3/35)vs. 22.9%(8/35)， χ2=2.696，P=0.101］。观察组中，肺结节≥1 cm的病例，一次穿刺达预定位置率为100%（28/28）；肺结节<1 cm的病例，一次穿刺达预定位置率为714%（5/7）。结论采用此三维激光引导装置，可用激光束准确引导，提高肺穿刺的准确性，减少并发症，缩短操作时间，且制作成本低，适宜在临床上推广。
Abstract:
ObjectiveTo explore the application value of selfdeveloped 3D laser guidance device in CT guided percutaneous puncture biopsy of pulmonary nodules. MethodsThe 3D laser guidance device was composed of a stainless steel double arch bracket, a laser goniometer, a slider and a guide bracket. The laser goniometer and guide bracket were fixed on the slider. The laser goniometer can rotate or change the angle (the angle between the laser and the horizontal), and project the cross laser at the corresponding angle at the front end. The angle between the ray of cross laser focus and the ground was equal to the angle shown on the goniometer. A total of 70 cases of pulmonary nodules from January to December 2018 were divided into observation group (3D laserguided puncture) or control group (conventional puncture) by paired method. The rate of achieving the predetermined position, the number of CT scans during the puncture process, the puncture operation time and the incidence of complications were compared between the two groups.ResultsAs compared with the control group, the observation group had higher rate of achieving the predetermined position on one session ［94.3% (33/35) vs. 45.7% (16/35), χ2=19.660, P=0.000］, fewer CT scans ［(3.1±0.2) vs. (4.1±1.3) times, t=-4.731, P=0.000］, shorter puncture operation time ［(19.9±4.1) min vs. (28.3±9.8) min, t=-4.684, P=0.000］, and lower incidence of complications ［8.6% (3/35) vs. 22.9% (8/35), χ2=2.696, P=0.101］. For cases with pulmonary nodules ≥ 1 cm in the observation group, the rate of achieving the predetermined position was 100% (28/28). For cases of pulmonary nodules <1 cm, the rate of achieving the predetermined position was 71.4% (5/7).ConclusionsWith the 3D laser guiding device, the performance can be accurately guided by the laser beam to improve the accuracy of lung puncture, reduce complications and shorten the operation time. Its low cost is suitable for clinical application.

参考文献/References:

[1]Birchard KR.Transthoracic needle biopsy.Semin Interv Radiol,2011,28(1):87-97.
[2]王玉涛,赵晓东,王海涛,等.低剂量CT引导肺活检对肺炎型肺癌的诊断价值.中国微创外科杂志,2013,13(8):740-742．
[3]Carillo GA,Vázquez JE,Villar AF.Prevalence of benign pulmonary lesions excised for suspicion of malignancy: could it reflect a quality managment index of indeterminate lung lesions?KJTCVS,2014,47(5):458-464.
[4]Tosi D,Mendogni P,Carrinola R,et al.CTguided fineneedle aspiration biopsy of solitary pulmonary nodules under 15 mm in diameter:time for an afterthought?J Thorac Dis,2019,11(3):724-731.
[5]Heerink WJ,de Bock GH,de Jonge GJ,et al.Complication rates of CTguided transthoracic lung biopsy: metaanalysis.Eur Radiol,2016,27(1):138-148.
[6]Jeon MC,Kim JO,Jung SS.CTguided percutaneous transthoracic needle biopsy using the additional laser guidance system by a pulmonologist with 2 years of experience in ctguided percutaneous transthoracic needle biopsy.Tuberc Respir Dis (Seoul),2018,81(4):330-338.
[7]杨清杰,胡蒙,郭明.新型三维穿刺定位引导器在经皮肺穿刺活检术中的应用.中国微创外科杂志,2016,16(11):1019-1022.
[8]Wu CC,Maher MM,Shepard JA.Complications of CTguided percutaneous needle biopsy of the chest:prevention and management.AJR Am J Roentgenol,2011,196(6):W678-W682.
[9]Takeshita J,Masago K,Kato R,et al.CTguided fineneedle aspiration and core needle biopsies of pulmonary lesions:a singlecenter experience with 750 biopsies in Japan.AJR Am J Roentgenol,2015,204(1):29-34.

备注/Memo

备注/Memo:
*通讯作者，Email：yqj00001@163.com①现工作单位：福建医科大学附属厦门弘爱医院胸外科，厦门361000
更新日期/Last Update: 2020-03-03