Clinical Observation Of Pulmonary Function Changes Before And After Microwave Ablation Of Pulmonary Ground-glass Nodules

Objective To compare the changes of pulmonary function before and after the operation of CT-guided microwave ablation(MWA)and simultaneous percutaneous core needle biopsy for pulmonary ground-glass nodule(GGN),the ultimate purpose is to guide clinical treatment.Methods From December 2017 to February 2021 21 patients diagnosed as pulmonary ground-glass nodule by chest thin layer CT scan simultaneously enhanced scan were collected and all patients who had carryed out CT-guided simultaneous percutaneous core needle biopsy and microwave ablation were unable or unwilling to undergo thoracoscopic surgery for various reasons.Pulmonary function examination and chest thin layer CT scan were assessed before ablation surgery,then reexamined at the time of 3 days and half a year post-operative.The data of forced vital capacity(FVC),forced expiratory volume in one second(FEV1),FEV1%,maximal voluntary ventilation(MVV)and peak expiratory flow(PEF)before and after surgery was compared with the differences between groups.The CT imaging evolution to the ablation lesions of pulmonary ground-glass nodules was simultaneously observed.Results A total of 29 lesions were completely ablated among 21 patients with pulmonary ground-glass nodule,all of which were assessmented by immediate imaging change during surgerys.The range of post-operative lesions was gradually reduced through follow-up chest thin layer CT scan,and most of lesions left over the fibrous cord scars after 6 months.Pulmonary function at the time of 3 days post-operative was compared with pre-operation.There was a significant difference in FVC,FEV1,MVV and PEF(p values were as follows: 0.044、0.037、0.017、0.013),however the p value of FEV1% was 0.623,indicating no significant difference.The comparison of pulmonary function at the time of 6 months post-operative with pre-operation showed that there was no significant difference in FVC,FEV1,FEV1%,MVV and PEF(p values were as follows: 0.875、0.954、0.791、0.872、0.940).Conclusion(1)Pulmonary function is impaired in the early period post-operative after the operation of CT-guided microwave ablation and simultaneous percutaneous core needle biopsy for GGN.The number of ablations should be controlled for patients suffering from multiple pulmonary nodules.However,there is a little change for FEV1% compared before and after surgery,which suggests that the operation has little impact on patients with obstructive airway disease.(2)The pulmonary function of most patients can be restored to the pre-operative state within half a year after surgery,which provides a basis for patients of multiple pulmonary nodules who need to splite into multiple operations and is helpful to the development of clinical protocols for such patients.(3)Microwave ablation of pulmonary GGN can be used as a supplementary treatment for some patients who are unable or unwilling to undergo thoracoscopic surgery for various reasons.It is worthy of the further clinical exploration and research.