三维重建技术联合支气管高频通气在肺段切除术中的临床应用分析

Clinical application analysis of three-dimensional reconstruction combined with high frequency bronchial ventilation in segmentectomy of lung

目的:分析三维重建技术联合支气管高频通气在胸腔镜解剖性肺段切除术中的应用价值。方法:回顾分析2015年1月1日至2022年1月1日以肺结节入院行胸腔镜解剖性肺段切除术的264例患者的临床资料。按照术中肺段间平面确定方式分为实验组(n=148)与对照组(n=116),实验组采用三维重建技术联合支气管高频通气法,对照组采用三维重建技术联合膨胀萎陷法。结果:两组患者年龄、性别、吸烟史、第一秒用力呼气量/用力肺活量、最大通气量、肺结节直径、术中出血量、术后引流量、拔除引流管时间、拔管后住院时间、术后并发症发生率差异无统计学意义(P>0.05),手术时间[(95.00±32.69)min vs.(106.29±27.68)min,P=0.018]、段间平面出现时间[(2.27±1.00)min vs.(14.82±3.27)min,P<0.001]差异有统计学意义。结论:三维重建技术联合支气管高频通气有助于提高肺结节定位的准确性与安全性,提高外科医生对患者个体肺解剖的认识,缩短段间平面出现时间与手术时间,在胸腔镜肺段切除术中具有一定的临床应用价值。

Objective:To analyze the application value of three-dimensional reconstruction combined with bronchial high-f requency ventilation in thoracoscopic anatomical segmental resection of lung.Methods:Clinical data of 264 patients who underwent thoracoscopic anatomical segmentectomy from Jan.1,2015 to Jan.1,2022 were retrospectively analyzed.According to the method of d etermining the plane between lung segments during operation,patients were divided into experimental group(n=148)and control group(n=116).The experimental group used three-dimensional reconstruction combined with bronchial high-frequency ventilation,while the control group used three-dimensional reconstruction combined with inflation and collapse.Results:There was no significant difference between experimental group and control group in age,gender,smoking history,forced expiratory volume in 1 second/forced v ital capacity,maximal ventilation,diameter of pulmonary nodules,intraoperative blood loss,postoperative drainage volume,drainage tube removal time,hospital stay after extubation,and postoperative complication rate(P>0.05).There were statistically significant differences between the experimental group and control group in the operation time[(95.00±32.69)min vs.(106.29±27.68)min,P=0.018],appearance time of intersegmental plane[(2.27±1.00)min vs.(14.82±3.27)min,P<0.001].Conclusions:Three-d imensional reconstruction combined with bronchial high-frequency ventilation is helpful to improve the accuracy and safety of pulmonary nodule location,improve surgeon's understanding of the patient's individual lung anatomy,shorten the appearance time of the intersegmental plane and the operation time.It has certain practical value of clinical application in the thoracoscopic segmentectomy.