CT引导下亚甲蓝与弹簧圈定位在肺磨玻璃结节术前定位的临床价值比较

Comparison of the Clinical Value of CT-Guided Methylene Blue and Coil Localization in the Preoperative Localization of Pulmonary Ground-Glass Nodules

摘要: 目的：比较弹簧圈和亚甲蓝用于肺磨玻璃结节术前定位的有效性和安全性。方法：回顾性分析2023年3月至2024年8月在安徽医科大学第二附属医院使用亚甲蓝染色剂定位和弹簧圈定位对350例肺磨玻璃结节患者进行术前定位，其中使用亚甲蓝染色剂组患者为170例，弹簧圈定位组180例。每组定位后4小时内行胸腔镜手术，比较两种定位方法的有效性及安全性。结果：亚甲蓝染色剂组定位成功率为97.54%，弹簧圈组定位成功率为98.21%；两组定位成功率(97.54% vs 98.21%, P = 0.066)相似，与弹簧圈定位相比，亚甲蓝染色剂组术前定位所需时间短[(19.23 ± 10.72) min vs (14.86 ± 6.21) min, P = 0.009]，气胸发生率较弹簧圈组低(5.34% vs 0.33%, P = 0.006)；穿刺后肺内出血发生率较弹簧圈组低(3.52% vs 0.29%, P = 0.003)；定位后疼痛持续时间较弹簧圈组少[(41.26 ± 15.09) min vs (21.05 ± 8.42) min, P = 0.001]。结论：CT引导下亚甲蓝术前定位效果好，安全，并发症发生率低，值得临床推广。

Abstract: Objective: To compare the efficacy and safety of coils and methylene blue for preoperative localization of pulmonary ground-glass nodules. Methods: A retrospective analysis was conducted on the preoperative localization of 350 patients with pulmonary ground-glass nodules in the Second Hospital of Anhui Medical University from March 2023 to August 2024 using methylene blue staining agent localization and coil localization. Among them, there were 170 patients in the methylene blue staining agent group and 180 patients in the coil localization group. Thoracoscopic surgery was performed within 4 hours after positioning in each group to compare the effectiveness and safety of the two positioning methods. Results: The localization success rate of the methylene blue staining agent group was 97.54%, and that of the coil group was 98.21%. The success rates of positioning in the two groups (97.54% vs 98.21%, P = 0.066) were similar. Compared with coil positioning, the preoperative positioning time required in the methylene blue staining agent group was shorter [(19.23 ± 10.72) min vs (14.86 ± 6.21) min, P = 0.009]. The incidence of pneumothorax was lower than that in the coil group (5.34% vs 0.33%, P = 0.006). The incidence of intra-pulmonary hemorrhage after puncture was lower than that in the coil group (3.52% vs 0.29%, P = 0.003). The duration of pain after positioning was shorter than that in the coil group [(41.26 ± 15.09) min vs (21.05 ± 8.42) min, P = 0.001]. Conclusion: CT-guided preoperative localization of methylene blue has a good effect, is safe, and has a low incidence of complications. It is worthy of clinical promotion.