三维重建技术在胸腔镜下肺段切除术中的应用效果分析

刘俊 龚军 熊薇 曾庆武

【摘要】 目的：分析三維重建技术在胸腔镜下肺段切除术中的应用效果。方法：回顾性分析本院2019年2月-2021年1月收治的80例实施胸腔镜下肺段切除术患者的临床资料，按照患者选择方案将其划分为对照组和观察组。对照组40例，采用常规观察增强CT图片制定手术方案;观察组40例，运用三维重建制定并实施个体化的胸腔镜肺段切除术。比较两组的手术效果。结果：观察组患者术后总有效率92.5%显著高于对照组67.5%（P<0.05）;观察组手术时间（114.37±22.39）min、住院时间（10.51±2.50）d

均短于对照组的（145.93±20.78）min、（13.98±2.89）d，观察组的术中出血量（120.79±16.42）mL少于对照组的（159.38±18.27）mL，差异均有统计学意义（P<0.05）。两组患者并发症发生率比较，差异无统计学意义（P>0.05）。结论：在胸腔镜下肺段切除术中应用三维重建技术，可以辅助医师在术前精确规划手术方案，降低手术难度，安全可靠，患者受益多，值得广大医师临床实践。

【关键词】 三维重建技术 肺段切除术 胸腔镜 肺部肿瘤

Effect of Three-dimensional Reconstruction Technology in Thoracoscopic Segmentectomy/LIU Jun， GONG Jun， XIONG Wei， ZENG Qingwu. //Medical Innovation of China， 2021， 18（35）： 0-031

[Abstract] Objective： To analyze the application effect of three-dimensional reconstruction technology in thoracoscopic segmentectomy. Method： Retrospective analysis of the clinical data of 80 patients undergoing thoracoscopic segmentectomy in our hospital from February 2019 to January 2021， according to the patient selection plan， it is divided into a control group and an observation group. 40 cases in the control group， used routine observation to enhance CT images to formulate surgical plans， 40 cases in the observation group ，used three-dimensional reconstruction to formulate and implement individualized thoracoscopic segmentectomy. The surgical results of the two groups were compared. Result： The total postoperative effective rate in observation group was 92.5% significantly higher than 67.5% in control group （P<0.05）. The operative time （114.37±22.39） min and hospital stay （10.51±2.50） d in the observation group were shorter than （145.93±20.78） min and （13.98±2.89） d

in the control group， the intraoperative blood loss in the observation group （120.79±16.42） mL was less than （159.38±18.27） mL in the control group， the differences were statistically significant （P<0.05）. There was no significant difference in the incidence of complications between two groups （P>0.05）. Conclusion： The application of three-dimensional reconstruction technology in thoracoscopic segmental lung resection can assist physicians in precise preoperative planning of the surgical plan， reduce the difficulty of surgery， be safe and reliable， patients benefit more， and it is worthy of clinical practice by the majority of physicians.

[Key words] 3D reconstruction technology Segmentectomy Thoracoscopy Lung tumors

First-author’s address： Xinyu People’s Hospital， Xinyu 338000， China

doi：10.3969/j.issn.1674-4985.2021.35.007

近年来，肺癌的发病率和致死率在不断上升，已位列各类肿瘤死亡首位[1]。而随着临床低剂量螺旋CT检查在肺癌筛查和常规体检中的广泛应用，越来越多的以肺结节为主要表现症状的早期肺癌和老年肺癌患者被发现[2-4]。肺叶切除术是目前早期肺癌的标准手术方式，但对于高龄患者由于大部分人其基础病较多，耐受性差，术后并发症增多等影响因素，开展此手术并不合适[5]。有研究发现，对于此类患者肺段切除术与肺叶切除术疗效基本一致，同时还可降低手术并发症发生率和死亡率，但该手术对精确度、医师经验等方面要求较高[6]。……