ABSTRACT
Objective:To retrospectively analyze the efficacy of video-assisted thoracoscopic surgery (VATS) in the treatment of solitary pulmonary nodule (SPN) and related factors affecting the diagnosis of benign and malignant SPN.Methods:The clinical data and surgical conditions of 317 patients with SPN who were resected by VATS and diagnosed by pathology in Chaoyang Central Hospital from January 2017 to December 2019 were retrospectively analyzed.The patient′s surgical efficacy and corresponding imaging features were explored.Results:Of the 317 patients, 124 (39.1%) cases underwent uniportal VATS and 193(60.9%) cases underwent multi-portal-portal VATS, 195(61.5%) cases had lobectomy, 16(5.1%) cases had anatomical segmentectomy, and 106(33.4%) cases had wedge resection. The operation time of the whole group was 50 - 210 (146.5 ± 34.7) min, intraoperative blood loss was 10 - 180 (69.3 ± 31.5) ml, thoracic drainage tube retention time was 2 - 7 (3.7 ± 1.4) d, postoperative hospital stay was 3 - 21 (6.4 ± 1.8) d, and the complication rate was 1.0%(3/317). No perioperative death occurred. Among all the nodules, 98(31.0%) cases were benign nodules and 219(69.1%) cases were malignant. Multivariate analysis showed that maximum nodule diameter, lobulated sign, burr sign, vascular bundle sign and pleural sag sign were independent related factors for the diagnosis of benign and malignant nodules ( P<0.05). Conclusions:VATS has less trauma and fewer complications, which has important clinical value for the diagnosis and treatment of benign and malignant SPN. Nodule maximum diameter, lobulated sign, burr sign, vascular bundle sign, pleural pit sign are independent related factors that affect the diagnosis of benign and malignant SPN.
ABSTRACT
Objective To investigate the projects and effects of the comprehensive and conservative treatment of patients with keen osteoarthritis and meniscus injury.Methods 120 patients with keen osteoarthritis and meniscus injury were randomly divided into the control group A(n =40),B(n =40)and comprehensive treatment group C(n =40).Patients in group A were treated with ozone and glass sodium injection;Patients in group B were treated with ozone,glass sodium and Triamcinolone Acetonide injection;Patients in group C were treated with ozone, glass sodium and Triamcinolone Acetonide injection,superlaser local irradiation,glucosamine tablet oral,Lornoxicam intravenous injection.The effects of the treatment according to keen joints function scores were compared after two weeks and six months.Patients in group C were randomly divided into group C1(n =20)and group C2(n =20)after one year,patients in group C1 with the same treatment as patients in group A and oral glucosamine tablet for one course of treatment,patients in group C2 without any further treatment.The follow up was completed for two years. Results The excellent and good rate in group C was better than that of group B and group C after two weeks (70.0%,22.5%,42.5%,χ2 =18.152,6.146,P <0.01 or P <0.05).After six month,the excellent and good rate in group C was better than that of group A and group B (87.5%,42.5%,60.0%,χ2 =17.802,7.813,all P <0.01).There was no significant difference between group C1 and group C2 after one years(t1 =2.014,P <0.01). There was significant difference between group C1 and group C2 after two years(t2 =16.152,P <0.01).Conclusion The effects of comprehensive conservative treatment are better than simple keen joint injection in patients with keen osteoarthritis and meniscus injury.The function of keen joint with maintenance care treatment is better than without maintenance care.Comprehensive conservative and maintenance care treatment is a good clinical treatment project.