Analysis Of Clinical Features,diagnosis And Treatment Ot Pulmonary Nodules

Objective:To investigate and analyze the clinical characteristics,diagnosis and treatment status of 1112 cases of pulmonary nodules on the Internet,so as to provide basis for screening,early diagnosis,treatment follow-up and standardized diagnosis and treatment of high-risk groups of early lung cancer.Methods:A total of 1112 patients with pulmonary nodules from July 2015 to October 2018 in the Third Affiliated Hospital of SoochowUniversity respiratory medicine of Wang Zhigang medical Internet client as the research object,collecting the basic data of 1112 patients with pulmonary nodules with clinical data,basic information,including gender,age,time,place of residence,smoking history,disease history,clinical data including the chief complaint,pulmonary nodule density,nodule size,sarcoidosis,tumor location,shape,index and pathological results,review of the situation,clinical treatment and treatment,etc.,and input data classification into EXCEL spreadsheet,SPSS22.0 statistical software was used to analyze all the data.Results:The number of patients with pulmonary nodules was increasing rapidly year by year.The age of 1112 patients with pulmonary nodules ranged from 14 to 93 years old,with male(46.37±14.25)and female(48.51±13.61),and the difference in age was statistically significant(t=2.555,P<0.05).508 patients were found by physical examination,which became the main reason for seeking medical treatment for pulmonary nodules.Solitary solid nodules are the main types of pulmonary nodules.There were 1049 patients with clear clinical treatment recommendations,of which 6-12 months follow-up was the main method,and a part of solid pulmonary nodules were recommended to be reexamined for 1-3 months.Among the 96 patients who were recommended to receive PET-CT,only 50 patients received PET-CT.A total of 246 patients had follow-up records,including 172 patients with similar complex nodules,17 patients with nodules reduction,22 patients with nodules disappearing,22 patients with nodules increasing,and 13 patients with new nodules.By single factor analysis,the nodule density,follow-up time,chronic lung disease history,and nodule diameter were statistically significant(P<0.05);Unconditioned Logistic regression analysis showed that chronic pulmonary disease history and diameter<5mm were risk factors for nodule reduction.Nodules located in the upper lobe of the lung are risk factors for nodules enlargement.Pure ground glass nodules are new risk factors for nodules.Nodule loss was not associated with the above factors.Of the 1112 patients,33 underwent surgical resection.Postoperative pathology showed 23 cases of malignant pulmonary nodules and 10 cases of benign nodules.Among them,5(21.74%)patients with malignant pulmonary nodules were found by physical examination.The proportion of women in malignant nodules group was significantly higher than that in benign nodules group(P<0.05).The proportion of patients with malignant nodules receiving treatment after symptoms was significantly higher than that of patients with benign nodules(P<0.05).The proportion of ground glass nodules in malignant nodules group was significantly higher than that in benign nodules group(P<0.05).Unconditioned Logistic regression analysis showed that benign and malignant nodules were correlated with gender and nodule density,with correlation coefficients of 2.32 and 1.87,respectively,which were risk factors for malignant nodules.Conclusions:1.Solid nodules with diameter<5mm and occurring in the upper lobe of the lung are clinically multiple types,and most of the pulmonary nodules have no clinical manifestations,but the possibility of malignant nodules cannot be excluded Among the malignant nodules,21.74%of the patients were accidentally found by low-dose chest CT examination through physical examination;2.The history of chronic lung disease and diameter<5mm are risk factors affecting the reduction of nodules,nodules is located in the upper lobe nodules increased risk factors,is pure glass grinding nodules nodules of new risk factors,follow-up time all is the protection factor on the changes of nodules,with chronic lung disease history,small nodules,pulmonary nodules in the upper lobes,pure glass grinding tubercle patients to strengthen dynamic follow-up,and master the nodularity gives corresponding processing;3.Benign and malignant nodules are related to ground glass nodules and are risk factors for malignant nodules.Patients with ground glass nodules should be closely monitored and intervention should be given as early as possible.4.The establishment of a well-known brand of respiratory doctors through the"Internet+medical health" medical mode can effectively manage the growing population of pulmonary nodules and promote the standardization of clinical diagnosis and treatment of pulmonary nodules.