基于三维重建的肺小结节患者右上肺叶解剖研究  

Anatomy of upper lung lobes of patients with small pulmonary nodules based on three-dimensional reconstruction of PC

作　　者：范坤 冯锦腾 王泓懿 张佳[1] 贺海奇 贾卓奇[1] 温小鹏[1] 吴齐飞[1] 付军科[1] 张广健[1] Fan Kun;Feng Jinteng;Wang Hongyi;Zhang Jia;He Haiqi;Jia Zhuoqi;Wen Xiaopeng;Wu Qifei;Fu Junke;Zhang Guangjian(Department of Thoracic Surgery,First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China;Department of Oncology,First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China)

机构地区：[1]西安交通大学第一附属医院胸外科,710061 [2]西安交通大学第一附属医院肿瘤内科,710061

出　　处：《中华胸心血管外科杂志》2020年第9期557-561,共5页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：西安交大校级教改重点项目(1812Z)。

摘　　要：目的应用三维重建分析右上肺叶肺段解剖模式,统计罕见变异类型。方法对我中心2017年10月至2020年3月101例拟行肺段切除术的肺小结节患者进行肺部结构三维重建,并将重建模型用于右上肺叶解剖结构的统计和分析。结果右上叶支气管以三分支型最常见(77/101),其次可见二分支型(16/101)和四分支型(7/101);右上叶肺动脉以二分支(70/101)最常见,其次可见单分支(19/101)和三分支(11/101),罕见情况下可见四分支型(1/101);右上叶肺静脉以二分支(63/101)最常见,其次为三分支(32/101)和单分支(6/101)。此外共统计到12种罕见变异:其中支气管出现2种变异,合计2例;肺动脉出现4种变异,累计13例;肺静脉出现6种变异,累计10例。结论肺部解剖结构复杂,变异众多,术者术前应充分掌握患者手术区域的肺段解剖结构,本研究对于开展右上叶解剖性肺段切除术有一定参考价值。Objective The extensive development of anatomical pulnonary segmentectomy requires thoracic surgeons to be familiar with the anatomical variations of the lung segment.The purpose of this study is to analyze the anatomical patterns of the right upper lobe lung segment using three-dimensional reconstruction,and to count rare variant types.Methods From October 2017 to March 2020,101 patients with small pulmonary nodules who were undergo segmental resection in our center were subjected to preoperative three-dimensional reconstruction of the lung structure,and the reconstruction data was retained for the statistics and analysis of the anatomical structure in the right upper lung lobe.Results The right upper lobe bronchus is the most common with three branches(77/101),followed by two branches(16/101)and four branches(7/101).The two branches(70/101)of the right upper lobe pulmonary artery are the most common,followed by single branch(19/101)and three branches(11/101).In rare cases,four branches(1/101 cases)can be seen.The two branches(63/101)of the right upper pulmonary vein were the most common,followed by three branches(32/101)and single branch(6/101).In addition,a total of 12 rare mutations were counted.There were 2 variants in the bronchus,totaling 2 cases;4 rare variants in the pulmonary artery,13 cases total;6 rare variants in the pulmonary vein,10 cases total.Conclusion The lung anatomy is complex and has many variations.The surgeon should fully grasp the anatomical structure of the lung segment of the patient's operating area before surgery,the data in this article will be a valuable reference for thoracic surgeons to carry out the upper right lobe segmentectomy.

关 键 词：肺段解剖 三维重建 肺小结节 

分 类 号：R734.2[医药卫生—肿瘤]