呼吸机设置对混合手术室肺结节定位精度的影响:单中心研究
Jiun Yi Hsia1,2, Hsu Chih Huang1,2, Kwong-Kwok Au1
1Division of Thoracic Surgery, Chung Shan Medical University Hospital, Taichung 402, Taiwan.
Journal of clinical medicine
|September 14, 2024
概括
传统的呼吸机设置 (8-10毫升/千克潮体积) 在混合手术室设置中提高了肺结节局部精度. 这种方法也稍微增强了患者的氧化,这表明早期肺癌治疗的好处.
科学领域:
- 肺部医学 肺部医学
- 胸部外科手术 胸部外科手术
- 医疗成像医学成像
背景情况:
- 混合手术室 (OR) 程序为胸腔镜手术前肺结节局部化提供了一种新的方法.
- 这种技术允许在积极通风期间进行局部化,克服了传统方法的局限性,需要同时进行呼吸运动.
- 早期肺癌治疗可以通过混合或肺结节局部化来推进,有可能取代传统的两阶段手术前计算机断层扫描引导局部化.
研究的目的:
- 在混合性OR中使用不同的呼吸机设置来评估肺结节局部的准确性.
- 评估潮体积对定位精度和患者氧化量的影响.
主要方法:
- 对176名在混合性手术室接受肺结节局部化的患者的回顾性分析.
- 两个呼吸器组的比较:传统 (潮体积8-10毫升/千克) 和肺保护策略 (潮体积<8毫升/千克).
- 定位精度定义为针到损伤距离≤5毫米,通过混合计算断层扫描成像进行评估.
主要成果:
- 在150名患者中确认了原发性肺癌.
- 多变量分析确定了潮体积,结节数和定位深度作为定位准确性的重要预测因素.
- 传统的通风器设置 (8-10毫升/千克潮体积) 组显示显著提高了定位准确性.
结论:
- 具有8-10毫升/千克潮体积的风扇设置显著提高了混合ORs中的肺结节局部精度.
- 这种方法还表明,患者的氧化水平略有改善.
- 需要进一步的随机对照试验来确认发现并建立最终的指导方针.
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