多层CT三维重建虚拟手术规划在胸腔镜亚肺叶切除术中的应用价值

Application value of multi-slice CT 3D reconstruction virtual surgical planning in thoracoscopic sublobectomy

目的针对多层CT三维重建虚拟手术规划方式,运用于胸腔镜亚肺叶切除术当中,具有的价值性进行分析。方法选取2017.6~2019.6于我院接受胸腔镜亚肺叶切除术治疗的192例肺癌患者,根据患者术前是否进行多层CT三维重建分为重建组96例和非重建组96例,分析两组患者手术情况、肺功能、术后并发症及随访结果。结果重建组患者手术时间、术后拔管时间、术后住院时间均短于非重建组(P<0.05),术中出血量、术后24h引流量及总引流量均少于非重建组(P<0.05),淋巴结清扫组数和个数均多于非重建组(P<0.05);重建组患者手术并发症发生率低于非重建组(P<0.05);术后3个月内,在两组中,患者FEVl%、FVC%、MVV在水平上,呈现出了先降后升状态(P<0.05),重建组患者术后2周的肺功能指标水平均高于非重建组(P<0.05);两组患者平均随访(14.86±2.39)个月,随访期间无患者死亡,无患者出现肿瘤复发、远处转移。结论胸腔镜亚肺叶切除术前多层CT三维重建虚拟手术规划能够实现精准的亚肺叶切除、减少手术损伤,安全有效,有助于患者术后肺功能早期恢复。

Objective:This paper analyzes the value of 3D multi-slice CT reconstruction virtual surgical planning in thoracoscopic sublobectomy.Methods:A retrospective analysis was performed on 6 patients with lung cancer who underwent thoracoscopic sublobectomy in our hospital.The patients were divided into reconstruction group(96 cases)and non-reconstruction group(96 cases)according to whether the patients received multi-slice CT three-dimensional reconstruction before surgery.The surgical condition,lung function,postoperative complications and follow-up results were analyzed in the two groups.Results:Not only in terms of surgical extubation time,but also in terms of hospital stay,it is relatively short.(P<0.05),and the intraoperative blood loss,drainage volume at 24h after surgery and total drainage volume were all less than those in non-reconstruction group(P<0.05),the number of groups and the number of lymph node dissection were more than those in non-reconstruction group(P<0.05).The incidence rates of surgical complications in reconstruction group were lower than those in non-reconstruction group(P<0.05).Within 3 months after surgery,the percentage of FEV1 in the predicted value(FEVl%),forced vital capacity as a percentage of expected value(FVC%)and maximal voluntary ventilation(MVV)were first decreased and then increased(P<0.05),and the lung function indexes at 2 weeks after surgery in reconstruction group were higher than those in non-reconstruction group(P<0.05).The average follow-up time was(14.86±2.39)months in the two groups.During follow-up,no patients died and no patients had tumor recurrence or distant metastasis.Conclusion:3D CT reconstruction can guide thoracoscopic sublobectomy to achieve accurate lesion localization and personalized surgical route planning before surgery,.reduce surgical injury,be safe and effective,and contribute to the early recovery of postoperative pulmonary function.