首页|CT三维重建技术辅助单孔胸腔镜肺段切除术术前规划的临床应用价值研究

CT三维重建技术辅助单孔胸腔镜肺段切除术术前规划的临床应用价值研究

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目的 探讨将二维CT影像进行三维重建后辅助单孔胸腔镜肺段切除术术前规划的临床应用价值.方法 本研究采用回顾性分析的研究方法,纳入 2021 年 6 月—2023 年 6 月在内蒙古自治区人民医院胸部肿瘤外科进行单孔胸腔镜手术治疗的肺部结节患者 78 例.按照术前是否进行胸部CT三维重建分为重建组 40 例和对照组 38 例.其中重建组先进行CT数据采集,再利用mimics软件对气管、血管、肺叶、肺结节进行三维重建,依据重建图像进行术前规划,术中按照重建图像进行精准切除.对照组依照术前CT扫描对结节定位,进行病灶切除.两组手术均由同一位高资历术者完成.记录两组患者结节大小、形态、位置、手术时长、术中出血量、术后住院时间、引流管拔管时间、总引流量、术后并发症及术后病理等指标,最后进行数据的统计与分析,对比两组的临床效果.结果 两组患者的基线资料、结节的大小、形态、位置比较,差异无统计学意义(P>0.05).重建组手术时长和引流管拔管时间均明显短于对照组,术中出血量低于对照组,差异有统计学意义(P<0.05).两组术后住院时长、引流管拔管时间、术后病理比较,差异无统计学意义(P>0.05).两组术后并发症发生率、术后半年随访并发症发生率比较,差异无统计学意义(P>0.05).结论 将二维CT图像进行三维重建,辅助单孔胸腔镜肺段切除术术前规划,定位准确、手术用时短、出血量少,术后住院时间短,可提高单孔胸腔镜下肺段切除术的效率,使临床医生在术前更加了解患者病情,手术更加安全,患者的愈后更好,利于肺结节的诊断和治疗,具有较大的临床应用价值.
CT three-dimensional reconstruction assisted preoperative planning for single-port thoracoscopic pulmonary segmentectomy clinical value
Objective To investigate the clinical value of three-dimensional reconstruction of CT images in assisting preoperative planning of single-port thoracoscopic lung segmentectomy.Methods 78 patients with pulmonary nodules who underwent single-port thoracoscopic surgery in the Department of Thoracic Oncology,Inner Mongolia Autonomous Region People's Hospital from June 2021 to June 2023 were enrolled in this study by retrospective analysis.The patients were divided into reconstruction group(n=45)and control group(n=40)according to whether preoperative three-dimensional reconstruction was performed.In the reconstruction group,CT data were collected first,and then 3D reconstruction of trachea,blood vessel,lung lobe and lung nodule was performed by mimics software.Preoperative planning was performed according to the reconstructed image,and accurate resection was performed according to the reconstructed image during operation.In the control group,the nodules were located according to preoperative CT scan and the lesions were resected.Both groups were performed by the same highly qualified surgeon.The nodule size,shape,location,operation duration,intraoperative blood loss,postoperative hospital stay,drainage tube extubation time,total drainage volume,postoperative complications and postoperative pathology were recorded in the two groups.Finally,the data were statistically analyzed to compare the clinical effects of the two groups.Resluts There was no statistical difference between the two groups in the baseline data and the size,shape and location of nodules(P>0.05).The operation time and drainage tube extubation time of the reconstruction group were significantly shorter than that of the control group,and the intraoperative blood loss was lower than that of the control group(P<0.05).There were no significant differences in postoperative hospital stay,drainage tube extubation time,postoperative pathology,and total hospital cost between the two groups(P>0.05).There was no statistical difference between the two groups in the incidence rate of postoperative complications and the incidence rate of postoperative complications in the follow-up of six months(P>0.05).Conclusion The three-dimensional reconstruction of two-dimensional CT images can assist the preoperative planning of single-port thoracoscopic pulmonary segmentectomy,which can improve the efficiency of single-port thoracoscopic pulmonary segmentectomy,make clinicians better understand the patient's condition before operation,make the operation safer,and make the patient better after recovery.It is beneficial to the diagnosis and treatment of pulmonary nodules and has great clinical application value.

Three-dimensional reconstructionSingle-port thoracoscopyPulmonary nodulesSegmentectomyPreoperative planning

李艳娜、夏慧琳、朱丹丹、朱永丽

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内蒙古自治区人民医院医学工程处,呼和浩特 010017

三维重建 单孔胸腔镜 肺结节 肺段切除术 术前规划

内蒙古自治区科技成果转化专项

2021CG0052

2024

现代仪器与医疗
中国科学器材公司

现代仪器与医疗

影响因子:1.47
ISSN:2095-5200
年,卷(期):2024.30(4)
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