协和医学杂志2026，Vol.17Issue(3)：646-651,6.DOI:10.12290/xhyxzz.2026-0185
雾化吸入吲哚菁绿检测肺切除术中漏气的双中心临床研究
Dual-Center Clinical Study on Detection of Intraoperative Air Leak During Pulmonary Resection Using Nebulized Indocyanine Green
王振帆 1赵颂晶 2姜瑞恒 3崔卓尔 1陈应泰 3周健 1陈克终 1李运1
作者信息
- 1. 北京大学人民医院 胸外科,北京 100044||北京大学人民医院 胸部肿瘤研究所,北京 100044||中国医学科学院早期非小细胞肺癌智能诊疗创新单元(2021RU002),北京 100044||北京大学临床医学高等研究院,北京 100191
- 2. 北京大学医学部,北京 100191
- 3. 北京航天总医院胸外科,北京 100076
- 折叠
摘要
Abstract
Objective To evaluate the clinical value of nebulized indocyanine green(ICG)combined with near-infrared fluorescence imaging for intraoperative detection of air leaks during pulmonary resection.Methods This was a two-center randomized controlled trial enrolling patients undergoing thoracoscopic pulmo-nary resection.After enrollment,patients were randomly divided into an experimental group and a control group.The experimental group received nebulized ICG and fluorescence imaging in addition to the conventional water immersion test,while the control group underwent the water immersion test alone.Intraoperative air leak detec-tion and postoperative air leak incidence were compared between the two groups.Multivariable logistic regression analysis was performed to assess the association between ICG nebulization intervention and postopera-tive air leaks after adjusting for confounding factors including age,sex,smoking history,history of respiratory disease,surgical procedure,and study center.Results A total of 181 patients were enrolled(90 in the exper-imental group,91 in the control group).The experimental group showed significantly higher intraoperative air leak detection rate(37.8％vs.19.8％,P=0.003)and median number of detected air leaks[0(0,1)vs.0(0,0),P= 0.004]compared with the control group.The proportion of patients developing postoperative air leaks was significantly lower in the experimental group than in the control group(25.6％vs.50.5％,P<0.001),and the median chest tube duration was significantly shorter[3(2,4)vs.4(3,5)days,P= 0.008].Multivariable logistic regression analysis showed that ICG nebulization intervention was an inde-pendent protective factor against postoperative air leaks(OR=0.34,95％CI:0.17-0.68,P= 0.002).The mean time for ICG nebulization was 37 seconds,and no ICG-related adverse events occurred in any patient dur-ing the intraoperative period or within one month postoperatively.Conclusion Nebulized ICG combined with near-infrared fluorescence imaging significantly improves intraoperative detection of air leaks,reduces the inci-dence of postoperative air leaks,and shortens chest tube duration.This technique is convenient,safe,and holds important clinical value for application.关键词
雾化吸入/吲哚菁绿/胸腔镜手术/肺漏气Key words
inhalation/indocyanine green/video assisted thoracoscopic surgery/air leak分类
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王振帆,赵颂晶,姜瑞恒,崔卓尔,陈应泰,周健,陈克终,李运..雾化吸入吲哚菁绿检测肺切除术中漏气的双中心临床研究[J].协和医学杂志,2026,17(3):646-651,6.
