摘要
目的探讨计算机辅助3D-CT重建联合3D模型打印技术在双侧肺动脉解剖类型和少见变异分析中的临床应用。方法回顾性分析2019年1月—2022年2月在宁波市第一医院胸外科接受胸腔镜下解剖性肺部病损切除术547例患者的临床资料,按照是否行术前3D-CT重建和3D模型打印分为3D-CT重建联合打印技术组[n=298,男87例、女211例,年龄(53.84±12.94)岁]、3D-CT重建组[n=148,男55例、女93例,年龄(54.21±11.39)岁]和非3D组[n=101,男28例、女73例,年龄(53.17±10.60)岁]。结果无论是右肺还是左肺手术,3D-CT重建联合打印技术组患者的手术时间[右侧:(125.61±20.99)min,左侧:(119.26±28.44)min]均短于3D-CT重建组[右侧:(130.48±11.28)min,左侧:(125.51±10.59)min]和非3D组[右侧:(134.45±10.20)min,左侧:(130.44±9.53)min];术中出血量[右侧:(20.92±8.22)mL,左侧:(16.85±10.43)mL]和3D-CT重建组[右侧:(21.13±8.97)mL,左侧:(19.09±7.01)mL]差异无统计学意义,少于非3D组[右侧:(24.44±10.72)mL,左侧:(23.72±11.45)mL]。右肺动脉共发现7例血管变异,变异率3.91%。左肺动脉共出现21例血管变异,变异率17.65%。首次发现2例四支型舌段肺动脉。结论术前利用CT影像计算机3D-CT重建联合3D模型打印技术,有助于临床医生制定精确的手术方案,缩短手术时间,减少术中出血量。
Objective To explore the clinical applications of 3D-CT reconstruction combined with 3D printing in the analysis of anatomical types and variations of bilateral pulmonary arteries.Methods From January 2019 to February 2022,the clinical data of 547 patients who underwent anatomical lung lesion resection in our hospital were retrospectively collected.They were divided into a 3D-CT reconstruction plus printing technology group(n=298,87 males and 211 females aged 53.84±12.94 years),a 3D-CT reconstruction group(n=148,55 males and 93 females aged54.21±11.39 years),and a non-3D group(n=101,28 males and 73 females aged 53.17±10.60 years).Results In the 3D-CT reconstruction plus printing technology group,the operation time of patients(right:125.61±20.99 min,left:119.26±28.44min)was shorter than that in the 3D-CT reconstruction group(right:130.48±11.28 min,left:125.51±10.59 min)and non-3D group(right:134.45±10.20 min,left:130.44±9.53 min),which was not associated with the site of surgery;intraoperative blood loss(right:20.92±8.22 mL,left:16.85±10.43 mL)was not statistically different compared with the 3DCT reconstruction group(right:21.13±8.97 mL,left:19.09±7.01 mL),but was less than that of the non-3D group(right:24.44±10.72 mL,left:23.72±11.45 mL).Variation was found in the right pulmonary artery of 7(3.91%)patients and in the left pulmonary artery of 21(17.65%)patients.We first found four-branched lingual pulmonary artery in 2 patients.Conclusion Preoperative CT image computer-assisted 3D reconstruction combined with 3D printing technology can help surgeons to formulate accurate surgical plans,shorten operation time and reduce intraoperative blood loss.
作者
王龙飞
陈求名
励新健
赵伟军
吕望
梁志刚
胡坚
WANG Longfei;CHEN Qiuming;LI Xinjian;ZHAO Weijun;LV Wang;LIANG Zhigang;HU Jian(Department of Thoracic Surgery,Ningbo First Hospital,Ningbo,315000,Zhejiang,P.R.China;Department of Thoracic Surgery,The First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou,310000,P.R.China)
出处
《中国胸心血管外科临床杂志》
CSCD
北大核心
2022年第7期867-877,共11页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
基金
2022年浙江省医药卫生计划项目(2022KY1102)。
关键词
3D-CT重建
3D打印
肺动脉
血管变异
胸外科
3D reconstruction
3D printing
pulmonary artery
anatomic variation
thoracic surgery
