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OA

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.