3D打印技术在周围型肺癌手术规划中的应用  

Application of 3D Printing Technology in Surgical Planning of Peripheral Lung Cancer

作　　者：董庆[1] 刘成[1] 张凯[1] 赵桂彬[1] 韩敬泉[1] 崔键[1] DONG Qing;LIU Cheng;ZHANG Kai;ZHAO Gui-bin;HAN Jing-quan;CUI Jian(Thoracic Surgery Department,The Fourth Affiliated Hospital of Harbin Medical University,Harbin,Heilongjiang,150001,China)

机构地区：[1]哈尔滨医科大学附属第四医院胸外科

出　　处：《现代生物医学进展》2019年第18期3490-3493,3567,共5页Progress in Modern Biomedicine

基　　金：黑龙江省卫生计生委科研项目（2017-131）;哈尔滨医科大学创新科学研究资助项目（2016LCZX24）;黑龙江省应用技术研究与开发计划项目（GA14C101-08）

摘　　要：目的:通过比较计算机断层扫描,三维重建图像和3D打印在手术中显示肺动脉分支的能力,探讨3D打印技术在周围型肺癌手术规划中的应用价值。方法:2018年1月-2018年12月,同一胸外科治疗组中接受电视胸腔镜择期右肺上叶切除手术的周围型肺癌患者30例。随机分为3组,每组10例,分别通过计算机断层扫描,三维重建图像和3D打印进行术前手术规划。分别记录每组手术规划中的右肺上叶动脉分支数目,然后将这些记录与术中实际所见进行比较。结果:各组间患者一般资料无统计学差异。所有患者均有完整的CT扫描、三维重建、3D打印和术中动脉分支数据,且都接受了VATS解剖性右肺上叶切除术,术中进行顺利,无中转开胸,无术中大出血,术后无明显并发症和围手术期死亡,皆顺利出院。CT组的右肺上叶动脉分支数量为1.5±0.52,3DI组为2.1±0.57,3DP组为2.2±0.63。CT组、3DI组和3DP组分别与手术中所见比较,CT组存在统计学差异(P=0.025),其他两组无统计学意义。结论:3D打印技术在周围型肺癌手术规划中的效果优于计算机断层扫描,比三维重建图像更加直观,建议推广。Objective: Comparingthe ability of Computed tomography, 3D reconstruction and 3D printing to model pulmonary arterial branch we aim to identify the using of 3D printing technology for operative planning of peripheral lung cancer. Methods: We selected 30 patients undergoing right upper lobe resection by video-assisted thoracic surgery for peripheral lung cancer under a single surgeon group from January 2018 to December 2018. They were randomly divided into 3 groups, 10 in each group, and preoperative planning was performed by computed tomography, 3D reconstruction images and 3D printing to record the number of the right upper lobe artery branches separately, and these records were compared with actually number observed during surgery. Results: There was no statisticalsignificant differencebetween each groups in characteristics. All patients had complete CT scan, 3D reconstruction, 3D printing and intraoperative arterial branches data. All underwent right upper lobe resectionby VATS, the operation was successful, no conversion from VATS to thoracotomy, no major bleeding during the surgery, without obvious complications and death, all the patients left hospital smoothly. The branches number of right upper lobe artery in the CT group was 1.5±0.52, 2.1±0.57 in the 3DI group, and 2.2±0.63 in the 3DP group. Compared with those observed in the operation, there was statistical difference between the CT group(P=0.025), and the other two groups were not. Conclusion: 3D printing in the planning of peripheral lung cancer may suggest a benefit over contemporary available imaging modalities, and the use of 3D printing is more intuitive than 3D reconstruction.

关 键 词：3D打印 电视胸腔镜手术 非小细胞肺癌 手术规划 计算机断层扫描 三维重建图像 

分 类 号：R734.2[医药卫生—肿瘤] R655[医药卫生—临床医学]