广西医学

探讨CT引导下新型定位器拖尾法定位联合胸腔镜肺段手术治疗早期肺腺癌的效果。方法选取2020年11月至2021年12月在北京航天总医院治疗的早期肺腺癌患者110例，采用简单随机化法分为观察组和对照组，其中观察组（n=57）和对照组（n=53），观察组给予CT引导下新型定位器拖尾法定位联合胸腔镜肺段手术治疗，对照组给予常规定位联合胸腔镜肺段手术治疗，观察两组手术情况、手术前后肺功能、肿瘤标志物、生存质量变化及并发症情况。结果观察组定位时间、引流时间和术后住院天数分别为（8.12±1.41）min、（4.10±1.00）d和（9.40±1.51），明显短于对照组，差异有统计学意义（P＜0.05）；观察组一次定位准确率为91.23%，明显高于对照组，差异有统计学意义（P＜0.05）。观察组术后3个月最大通气量占预计量的百分比（MVV）、第1秒用力呼气容积（FEV1）、用力肺活量（FVC）和肺一氧化碳弥散量（DLCO）分别为（78.80±5.03）L、（1.90±0.68）L、（2.10±0.88）L和（19.40±2.24）ml/mmHg/min，明显高于对照组，差异有统计学意义（P＜0.05）。观察组和对照组术前及术后3个月癌胚抗原（CEA）、糖类抗原125（CA125）、细胞角蛋白21-1（CYFRA21-1）和鳞状细胞癌抗原（SCCAg）比较差异无统计学意义（P＞0.05）。观察组和对照组生存质量、并发症比较差异无统计学意义（P＞0.05）。结论 CT引导下新型定位器拖尾法定位联合胸腔镜肺段手术治疗早期肺腺癌有较好的效果，有助于术前定位，对患者肺功能影响小。

To investigate the effect of CT guided new locator tailing method combined with thoracoscopic lung surgery in the treatment of early lung adenocarcinoma. Methods: 110 patients with early lung adenocarcinoma treated in Beijing Aerospace General Hospital from November 2020 to December 2021, the patients were divided into observation group and control group by simple randomization, and observation group (n = 57) and control group (n = 53), the observation group was treated with CT guided new locator tailing method combined with thoracoscopic lung segment surgery, and the control group was treated with routine localization combined with thoracoscopic lung segment surgery, the operation conditions, lung function, tumor markers, quality of life and complications before and after operation were observed. Results: The localization time, drainage time and postoperative hospital stay in the observation group were (8.12 ± 1.41) min, (4.10 ± 1.00) d and (9.40 ± 1.51) d, respectively, which were significantly shorter than those in the control group, the difference was statistically significant (P < 0.05); The accuracy of one time localization in the observation group was 91.23%, which was significantly higher than that in the control group (P<0.05). Maximum ventilation as a percentage of predicted volume (MVV), forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), and pulmonary carbon monoxide diffusion volume (DLCO)in the observation group were (78.80 ± 5.03) l, (1.90 ± 0.68) l, (2.10 ± 0.88) l and (19.40 ± 2.24) ml / mmHg / min, respectively, which were significantly higher than those in the control group, the difference was statistically significant (P < 0.05). Preoperative and three months after operation, Carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), cytokeratin 21-1 (CYFRA21-1) and squamous cell carcinoma antigen (SccAg) in the observation group and control group, the difference was not statistically significant (P > 0.05). There was no significant difference in quality of life and complications between the observation group and the control group (P > 0.05).Conclusion: CT guided new locator tailing method combined with thoracoscopic lung surgery has a good effect in the treatment of early lung adenocarcinoma, which is conducive to preoperative localization, has little impact on patients'' lung function.