数字三维技术在慢性下肢静脉性溃疡治疗的应用研究  

Application of digital 3D technique in the treatment for chronic venous ulcer of the lower extremities

作　　者：张普生[1] 罗云峰[1] 方驰华[2] 史福军[1] 邓鉴文[1] 

机构地区：[1]南方医科大学珠江医院普通外科,广州510282 [2]南方医科大学珠江医院肝胆一科,广州510282

出　　处：《中国血管外科杂志（电子版）》2016年第3期208-211,共4页Chinese Journal of Vascular Surgery(Electronic Version)

基　　金：广东省医学科研基金项目(B2014258);南方医科大学科研启动计划(PY2015N013);广东省科技计划项目(2013B021800308);广东省科技计划项目(2014A020212495);广东省科技计划项目(2016A020215208)

摘　　要：目的 研究数字三维技术在慢性下肢静脉性溃疡治疗的应用。方法 入组2013年5月至2015年5月南方医科大学珠江医院115例（119条肢体）大隐静脉曲张合并慢性静脉性溃疡患者,采集其下肢CT静脉造影数据,利用数字三维技术进行图像分割及三维重建,然后对119条下肢静脉三维模型进行详细的手术方案设计及可视化手术预演,寻找小腿部、溃疡底部及其周边功能不全的交通支并准确定位,指导术中行大隐静脉激光闭合＋交通静脉激光闭合术。术后根据手术效果,评价数字三维技术在慢性下肢静脉性溃疡治疗的应用价值。结果 119条患者下肢静脉三维模型与实际患者完全吻合,深、浅静脉及各交通支相互关系清晰;术后119条肢体浅静脉曲张条消失,所有溃疡均在术后7-28天完全愈合,疗效满意;随访6-30个月,未见静脉曲张及溃疡复发。结论 数字三维技术有利于下肢交通静脉的寻找及定位,准确处理功能不全的深、浅静脉及交通支,有利于激光闭合静脉曲张及下肢慢性溃疡的愈合,减少静脉曲张及溃疡的复发。Objective To study the clinical value of digital 3D technique in the treatment for chronic venous ulcer of the lower extremities. Methods One hundred and fifteen patients （119 limbs） with chronic venous ulcer of the lower extremities admitted to our hospital between May 2013 and May 2015 were recruited. The CT venography （CTY） data of the 115 patients were segmented to reconstruct digital 3D models, which were imported into the Free Form Modeling Surgical System Platform for visual simulation surgery before operation. Endovenous laser treatment were then performed, and the accuracy and clinical value of digital 3D technique in the treatment for chronic venous ulcer of the lower extremities were analyzed. Results The 3D models faithfully represented the surgical anatomy of the patients and clearly displayed the 3D relationship among the deep vein, superficial vein and perforating vein. The varicose veins of the 119 limbs disappeared and all the ulcers were completely healed in 7 -28 days after surgery. No recurrence of the varicose veins and ulcers were found during the follow-up of 6 -30 months. Conclusion Digital 3D technique is helpful to locate the perforating vein of the lower extremities accurately and handle the insufficient perforating vein. It can also reduce the recurrence of the varicose veins and venous ulcer.

关 键 词：交通支静脉功能不全 静脉性溃疡 数字三维技术 三维重建 

分 类 号：R654.4[医药卫生—外科学]