Comparison Of Hook-wire And Methylene Blue Localization Under CT Guidance

Objective: To compare the clinical application of Hook-wire and methylene blue in preoperative localization of small pulmonary nodules(SPN)and ground glass nodules(GGO),and to explore the complications caused by localization.Methods: 73 patients with pulmonary nodules who underwent thoracoscopic surgery from December 2020 to January 2023 in the Department of Thoracic surgery of Autonomous region people’s Hospital were analyzed retrospectively,including 42 patients with percutaneous Hook-wire guided by CT(Hook-wire group)and 31 patients with percutaneous methylene blue localization guided by CT(methylene blue group).The clinical data of the two groups were compared.Results: 1、43 nodules were located in Hook-wire group and 31 nodules were located in methylene blue group.There was no significant difference in positioning time,positioning times and posture between the two groups.2、The incidence of pneumothorax after localization in the Hook-wire group was higher than that in the methylene blue group(13 cases of 28.6%vs.3 9.7% P=0.030 < 0.05,statistically significant).3 、 The incidence of intrapulmonary hemorrhage after localization in the Hook-wire group was higher than that in the methylene blue group(18 cases of 28.6%vs.59.7% P=0.015 < 0.05,statistically significant),and the incidence of chest pain after localization in the Hook-wire group was higher than that in the methylene blue group(18cases of 42.9%vs.6 19.4% P=0.035<0.05,statistically significant).4、The success rate of localization in methylene blue group was higher than that in Hook-wire group(71.4% of28 90.3%vs.30 cases P=0.048<0.05).5、The results of univariate analysis showed that the risk factors of pneumothorax were related to the history of lung disease,localization time,location mode,location times and positioning position(P<0.05).6.Multivariate logistic regression analysis showed that pulmonary disease history(OR=6.135,P=0.033),localization time(OR=7.657,P=0.011)and localization times(OR=7.062,P=0.029)were independent risk factors for pneumothorax after localization.7、The results of univariate analysis showed that the risk factors of intrapulmonary hemorrhage were related to the history of pulmonary disease,localization time,localization mode and localization times(P < 0.05).8.Multivariate logistic regression analysis showed that pulmonary disease history(OR=3.860,P=0.027)and location time(OR=4.127,P=0.021)were independent risk factors for intrapulmonary hemorrhage after localization.Conclusion: 1、Compared with CT-guided preoperative Hook-wire localization,CT-guided preoperative methylene blue localization has fewer overall complications and higher success rate.two。2、Lung disease history,localization time and localization times are the independent risk factors of pneumothorax after localization.3、The history of pulmonary disease and localization time are independent risk factors of intrapulmonary hemorrhage after localization.