CT引导下穿刺针定位在肺小结节胸腔镜手术中的应用效果

The Application Effect of CT-Guided Needle Localization in Thoracoscopic Surgery for Pulmonary Small Nodules

摘要: 目的：探讨CT引导下穿刺针定位技术在肺小结节胸腔镜手术中的临床应用价值，评估其定位准确性、手术效果及安全性。方法：运用回顾性分析研究方法，随机选取96例2024年1月至2024年12月在安徽医科大学第二附属医院胸外科住院期间诊断为肺小结节(直径 ≤ 2 cm)并接受胸腔镜手术的患者，其中48例术前采用CT引导下穿刺针定位(定位组)，48例未行术前定位(非定位组)。比较两组患者的术中结节识别时间、手术时间、切除范围、术中出血量、术后引流量、住院时间、术后并发症发生率、肿瘤复发率及远期生存率等指标。结果：定位组穿刺针定位成功率为97.9% (47/48)，无严重并发症发生。与非定位组相比，定位组术中结节识别时间显著缩短(2.93 ± 1.00 min vs. 9.75 ± 1.08 min, P < 0.05)，手术时间明显减少(41.50 ± 5.33 min vs. 61.30 ± 8.89 min, P < 0.05)。两组患者术后并发症发生率(8.33% vs. 4.17%, P > 0.05)无统计学差异。观察组患者术中结节识别时间、手术时间、切除范围、术中出血量、术后引流量、住院时间明显低于对照组(P < 0.05)；两组患者肿瘤复发率和远期生存率无明显差异(P > 0.05)。结论：CT引导下穿刺针定位可显著提高肺小结节胸腔镜手术的精准性和效率，缩短手术时间，减少不必要的肺组织切除，且安全性良好，值得临床推广应用。

Abstract: Objective: To evaluate the clinical application value of CT-guided needle localization in thoracoscopic surgery for small pulmonary nodules by assessing its localization accuracy, surgical efficacy, and safety. Methods: In this retrospective study, we randomly selected 96 patients with small pulmonary nodules (diameter ≤2 cm) who underwent thoracoscopic surgery at the Department of Thoracic Surgery, the Second Affiliated Hospital of Anhui Medical University from January 2024 to December 2024. The patients were divided into two groups: 48 cases with preoperative CT-guided needle localization (localization group) and 48 cases without preoperative localization (non-localization group). We compared various parameters between the two groups, including intraoperative nodule identification time, operation time, resection range, intraoperative blood loss, postoperative drainage volume, length of hospital stay, postoperative complication rate, tumor recurrence rate, and long-term survival rate. Results: The success rate of needle localization in the localization group was 97.9% (47/48), with no severe complications occurring. Compared with the non-localization group, the localization group showed significantly shorter intraoperative nodule identification time (2.93 ± 1.00 min vs. 9.75 ± 1.08 min, P < 0.05) and significantly reduced operation time (41.50 ± 5.33 min vs. 61.30 ± 8.89 min, P < 0.05). There was no statistically significant difference in postoperative complication rates between the two groups (8.33% vs. 4.17%, P > 0.05). The localization group demonstrated significantly better outcomes than the control group in terms of intraoperative nodule identification time, operation time, resection range, intraoperative blood loss, postoperative drainage volume, and length of hospital stay (P < 0.05). No significant differences were found in tumor recurrence rate or long-term survival rate between the two groups (P > 0.05). Conclusion: CT-guided needle localization can significantly improve the precision and efficiency of thoracoscopic surgery for small pulmonary nodules, shorten operation time, reduce unnecessary lung tissue resection, and demonstrate good safety profile, making it worthy of clinical promotion and application.