3D-CTBA联合3D打印在老年早期NSCLC胸腔镜肺段切除术中的应用效果及安全性

Efficacy and safety of 3D computed tomography bronchial angiography(3D-CTBA)combined with 3D printing in thoracoscopic segmentectomy of non-small cell lung cancer(NSCLC)in elderly

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打印在老年早期非小细胞肺癌(NSCLC)胸腔镜肺段切除术中的应用效果及安全性。方法选取2020年6月至2023年1月期间本院收治的70例老年早期NSCLC患者,对患者均行胸腔镜肺段切除术,按照随机数字表法将其分为3D-CTBA组(35例)及联合组(35例)。3D-CTBA组术前进行胸部CT增强扫描,并进行3D-CTBA,联合组在3D-CTBA组的基础上进行3D打印。检测并比较两组患者肺功能指标,统计并比较两组术中及术后相关指标,包括切缘距离、术中出血量及手术时间,术后引流量、术后置管时间及住院时间,观察两组患者术后并发症情况。结果与术前相比,两组患者术后肺活量(FVC)、第一秒用力呼气容积(FEV1)及每分钟最大通气量(MVV)水平均降低(P<0.05);与3D-CTBA组相比,联合组患者术后FVC、FEV1及MVV水平升高(P<0.05);与3D-CTBA组相比,联合组患者术切缘距离更大,术中出血量减少,手术时间缩短(P<0.05);与3D-CTBA组相比,联合组患者术后引流量减少,术后置管时间及住院时间缩短(P<0.05);3D-CTBA组、联合组并发症发生率分别为11.43%、8.57%,二者比较差异无统计学意义(P>0.05)。结论3D-CTBA联合3D打印用于老年早期NSCLC胸腔镜肺段切除术,能够降低手术操作对肺功能的影响,缩短手术时间,减少术中出血,同时能够有效控制切缘距离,减少术后并发症的发生,有利于患者康复。

Objective To explore the efficacy and safety of 3D computed tomography bronchial angiography(3D-CTBA)combined with 3D printing in thoracoscopic segmental resection of elderly patients with early non-small cell lung cancer(NSCLC).Methods 70 elderly patients with early NSCLC admitted to the hospital from June 2020 to January 2023 were selected,all of whom underwent thoracoscopic segmental resection.According to random number table method,the patients were divided into 3D-CTBA group(35 cases)and combined group(35 cases).The 3D-CTBA group underwent chest CT enhancement scanning before the surgery and 3D-CTBA,and the combined group underwent 3D printing based on the 3D-CTBA group.Pulmonary function indexes of the patients were detected and compared.Intraoperative and postop-erative related indexes,including incisal margin distance,intraoperative blood loss and operation time,postoperative drainage volume,postoperative catheterization time and hospital stay,were counted and compared.Postoperative complications were observed in two groups.Results Compared with preopera-tive,the levels of postoperative forced vital capacity(FVC),forced expiratory volume in the first second(FEV1)and maximum volume per minute(MVV)in both groups were decreased(P<0.05).Compared with 3D-CTBA group,the postoperative levels of FVC,FEV1 and MVV in combined group were increased(P<0.05).Compared with 3D-CTBA group,the patients in the combined group had a greater surgical margin distance,reduced blood loss and shortened operation time(P<0.05).Compared with 3D-CTBA group,postoperative drainage volume was reduced,postoperative catheterization time and hospital stay were shortened in combination group(P<0.05).The complication rates of 3D-CTBA group and combina-tion group were 11.43%and 8.57%,respectively,and there was no statistical difference between them(P>0.05).Conclusion The application of 3D-CTBA combined with 3D printing in the thoracoscopic segmental resection of NSCLC in the elderly can reduce the impact of surgical operation on lung function,shorten the opera-tion time and reduce intraoperative bleeding.At the same time,it can effectively control the distance of incisal margin,reduce the occurrence of postoperative complications,and it is conducive to the recovery of patients.