三维可视化技术在儿童实体肿瘤手术中的应用价值研究  

Application of three-dimensional visualization technology for pediatric solid tumors

作　　者：廖文戈 朱俊杰 张昊东 黄鸿[1] 王志刚[1] 彭强[1] Liao Wenge;Zhu Junjie;Zhang Haodong;Huang Hong;Wang Zhigang;Peng Qiang(Department of Pediatric Surgery Ⅱ,Cheangdu Women’s and Children’s Central Hospital,School of Medicine,University of Electronic Science and Technology of China,Chengdu 611731,China)

机构地区：[1]电子科技大学附属妇女儿童医院、成都市妇女儿童中心医院外二科,成都611731

出　　处：《临床小儿外科杂志》2023年第7期655-659,共5页Journal of Clinical Pediatric Surgery

基　　金：2021年成都市医学科研课题(2021030)

摘　　要：目的探讨术前三维可视化技术在儿童实体肿瘤手术中的应用价值。方法回顾性分析电子科技大学附属妇女儿童医院·成都市妇女儿童中心医院2019年1月至2021年12月收治的23例接受手术治疗的实体肿瘤患儿临床资料,按照术前是否完善三维可视化分为研究组(n=11)和对照组(n=12)。研究组基于CT数据对患儿影像学结果进行三维可视化处理,通过可视化模型了解肿瘤及周围脏器血管的空间三维关系,明确邻近血管有无变异情况,进行精确的术前规划(组织血管保护、预切除路径等),并在三维模型指导下行儿童实体肿瘤切除手术;对照组仅在传统CT图像指导下完成手术。收集两组患儿的一般资料和术中资料,并进行比较分析。结果23例均顺利完成手术。研究组和对照组的年龄分别为(3.1±0.9)岁和(2.1±0.6)岁;体重分别为(12.2±2.7)kg和(15.7±2.5)kg;住院时间分别为(11.4±1.8)d和(13.4±1.6)d;手术时间分别为(330.4±61.0)min和(208.8±30.7)min;术中出血量分别为(43.6±17.6)mL和(204.2±70.2)mL;术中输血人数分别为1例和6例;肿瘤最大直径分别为(8.0±0.8)cm和(10.5±1.2)cm;体积误差值分别为(4.3±0.9)cm^(3)和(15.4±1.6)cm^(3);研究组发生贫血1例、低蛋白血症1例、凝血功能异常1例,对照组发生贫血3例、低蛋白血症1例、凝血功能异常1例。研究组的术中出血量[(43.6±17.6)mL比(204.2±70.2)mL]、术中输血人数(1/11比6/12)均少于对照组,差异具有统计学意义(P<0.05)。结论术前三维可视化技术是评估儿童实体肿瘤手术可切除性的有效且简便的方法,对提高儿童实体肿瘤手术的精准性和安全性具有重要价值。Objective To explore the application value of preoperative three-dimensional visualization technology for pediatric solid tumors.Methods Retrospective analysis was performed for 23 children with solid tumors from January 2019 to December 2021.According to whether or not three-dimensional visualization was applied preoperatively,they were divided into two groups of study(n=11)and control(n=12).The research team performed three-dimensional visualization of computed tomography(CT)images,explored the spatial and three-dimensional relationship between tumors and adjacent organs and blood vessels and clarified whether or not adjacent blood vessels had mutations.Pecise preoperative planning was implemented under the guidance of three-dimensional model.The control group was operated merely under the guidance of traditional CT images.General profiles and intraoperative data of two groups were compared.Results All operations were successfully completed.The age of study and control groups was[(3.1±0.9)vs.(2.1±0.6)year],body weight[(12.2±2.7)vs.(15.7±2.5)kg]and length of hospitalization[(11.4±1.8)vs.(13.4±1.6)day].Regarding intraoperative data,operative duration of study and control groups was[(330.4±61.0)vs.(208.8±30.7)min],intraoperative blood loss[(43.6±17.6)vs.(204.2±70.2)mL]and frequency of intraoperative blood transfusion(transfusion/non-transfusion)[(1/10)vs.(6/6)],maximal tumor diameter[(8.0±0.8)vs.(10.5±1.2)cm]and volume error values[(4.3±0.9)vs.(15.4±1.6)cm^(3)].Regarding perioperative complications,anemia(n=1 vs.3),hypoproteinemia(n=1 vs.1)and abnormal coagulation function(n=1 vs.1)occurred in study group.In control group,anemia(n=3),incision infection(n=0),hypoproteinemia(n=1)and abnormal coagulation function(n=1).Intraoperative blood loss,blood transfusion and volume error of study group were all smaller than those of control group.The inter-group difference was statistically significant(P<0.05).Conclusion Preoperative three-dimensional visualization technology is both effective and convenient for

关 键 词：实体肿瘤疗效评价标准 成像 三维 外科手术 儿童 

分 类 号：R730[医药卫生—肿瘤]