3D-CTBA联合3D打印技术在肺癌胸腔镜肺段切除术中的应用价值

Application value of 3D-CTBA combined with 3D printing technology in thoracoscopic segmentectomy of lung cancer

目的:探究三维计算机断层扫描支气管血管成像(3D-CTBA)联合3D打印技术在肺癌胸腔镜肺段切除术中的临床应用效果。方法:选取接受胸腔镜肺段切除术的肺癌患者90例,采用随机双色球法分为试验组(45例)和对照组(45例)。对照组患者在术前接受薄层CT增强扫描,试验组在对照组的基础上加用3D-CTBA联合3D打印技术。比较两组患者手术中转率、肺叶转换率、围手术期指标(手术时间、术中出血量、术后引流量),以及术前和术后第15天肺功能指标[用力肺活量(FVC)、肺一氧化碳弥散因子(TLCO)、每分钟最大通气量(MVV)];统计两组患者术后1个月并发症发生情况。结果:试验组手术中转率、肺叶转换率显著低于对照组(均P<0.05);试验组手术时间、术中出血量、术后引流量显著低于对照组(均P<0.05)。术后第15天,两组患者FVC、TLCO、MVV水平低于术前,且试验组高于对照组(均P<0.05)。术后1个月内,试验组并发症总发生率低于对照组(P<0.05)。结论:在肺癌胸腔镜肺段切除术前应用3D-CTBA联合3D打印技术可对病灶位置进行定位,有效提升临床手术精准度和安全性,降低手术对患者的不良影响,有利于患者术后恢复。

Objective:To explore the clinical application effects of three-dimensional computed tomography bronchial angiography(3D-CTBA)combined with 3D printing technology in thoracoscopic segmentectomy of lung cancer.Methods:A total of 90 patients with lung cancer who received thoracoscopic segmentectomy were selected and divided into experimental group(45 cases)and control group(45 cases)by the random two-color ball method.The control group received thin-slice CT enhanced scanning before surgery,and the experimental group was additionally given 3D-CTBA combined with 3D printing technology on the basis of the control group.The surgical conversion rate,lung lobe conversion rate,perioperative indicators(surgical time,intraoperative blood loss,postoperative drainage volume)and lung function indicators(forced vital capacity[FVC],diffusing capacity of the lungs for carbon monoxide[TLCO],maximum ventilation volume per minute[MVV])before and 15 days after surgery were compared between the two groups.The complications at 1 month after surgery were counted in both groups.Results:The surgical conversion rate and lung lobe conversion rate in experimental group were significantly lower than those in control group(all P<0.05).The surgical time,intraoperative blood loss and postoperative drainage volume were significantly lower in experimental group than those in control group(all P<0.05).On the 15th day after surgery,the FVC,TLCO and MVV in both groups were significantly lower than those before surgery,and the indicators in experimental group were significantly higher than those in control group(all P<0.05).The total complication rate of experimental group was significantly lower than that of control group within 1 month after surgery(P<0.05).Conclusion:The application of 3D-CTBA combined with 3D printing technology before thoracoscopic segmentectomy for lung cancer can locate the lesion,effectively improve the accuracy and safety of clinical surgery,reduce the adverse effects of surgery on patients,and is conducive to postoperative recovery of patients.