3D重建及虚拟手术规划技术在肺结节定位、肺段血管支气管变异重建及手术中的应用

Application of three-dimensional reconstruction and virtual surgery planning in localization of pulmonary nodules,variant reconstruction of pulmonary vessels and bronchi and surgery

目的:结合数字化医学图像交互控制系统(Mimics),探讨3D重建技术及虚拟手术技术在肺结节定位肺段血管支气管变异重建及手术中的应用。方法:选取2018年6月—2020年6月在沈阳医学院附属第二医院实施胸腔镜下肺部分切除术的94例患者,将手术病人分为试验组(n=38,术前利用Mimics软件系统进行重建)与对照组(n=56,直接进行手术),比较两组手术所用时间、术中出血量、术后并发症的发生率、住院时间、术后胸腔引流量等指标。结果:试验组的手术时间短于对照组,术中出血量少于对照组,术后引流量少于对照组,差异均有统计学意义(P<0.05);在住院时间和常见并发症的发生率上两组之间没有显著差异(P>0.05)。结论:术前利用三维重建技术(Mimics)对肺部结节所在肺叶的血管、支气管等进行重构,并在术前进行虚拟手术演练,能够节省肺小结节切除所用手术时间,显著减少手术中出血量以及术后胸腔引流量,可以在肺结节切除术中发挥重要作用。

Objective Combined with the digital medical image interactive control system(Mimics),the application of 3D reconstruction technology and virtual surgery technology in pulmonary nodule location pulmonary segmental vascular bronchial variation reconstruction and surgery was discussed.Methods 94 patients who underwent thoracoscopic partial pneumonectomy in the Second Affiliated Hospital of Shenyang Medical College from June 2018 to June 2020 were selected,the surgical patients were divided into the experimental group(n=38,underwent reconstruction using the Mimics software system before surgery)and the control group(n=56,underwent direct surgery).The operation time,intraoperative blood loss,and postoperative complications were compared between the two groups.The incidence rate,hospital stay,postoperative thoracic drainage and other indicators.Results The operation time of the experimental group was shorter than that of the control group,the amount of intraoperative bleeding was less than that of the control group,and the postoperative drainage volume was less than that of the control group,the difference was statistically significant(P<0.05),and there was no significant difference between the two groups in the length of stay and the incidence of common complications(P>0.05).Conclusion Preoperative use of threedimensional reconstruction technology(Mimics software)to reconstruct the blood vessels,bronchi,etc.of the pulmonary lobe where the pulmonary nodules are located,and virtual surgical rehearsal before surgery can save the operation time for small pulmonary nodule resection and significantly reduce the operation time and the amount of bleeding and postoperative thoracic drainage.It can play an important role in pulmonary nodule resection.