虚拟仿真手术与常规手术对肾结石治疗效果的比较  

Comparison of the effect between virtual simulation operation and conventional operation for the treatment of kidney stones

作　　者：武利兵 高尚 许阳阳 王一丹 和雨洁 王海燕 李筱贺 李志军 WU Li-bing;GAO Shang;XU Yang-yang;WANG Yi-dan;HE Yu-jie;WANG Hai-yan;LI Xiao-he;LI Zhi-jun(Departmeng of Urinary Surgery,Liangxiang Hospital in Fangshan District,Beijing 102446,China;Department of Anatomy,Basic Medical College,Inner Mongolia Medical University,Hohhot 010110,China;Gradute School,Inner Mongolia Medical University,Hohhot 010110,China)

机构地区：[1]北京市房山区良乡医院泌尿外科,北京102446 [2]内蒙古医科大学基础医学院人体解剖学教研室,呼和浩特010010 [3]内蒙古医科大学研究生院,呼和浩特010110

出　　处：《解剖学报》2021年第4期609-617,共9页Acta Anatomica Sinica

基　　金：国家自然科学基金(81460330,81560348,81860383);内蒙古教育厅青年科技英才项目(njyt-15-b05);内蒙古自治区科技计划项目(2016);内蒙古自治区科技创新引导项目(2017);内蒙古自治区自然科学基金(2016ms08131);内蒙古医科大学科技百万计划基金(YKD2017KJBW012)。

摘　　要：目的重建肾脏的三维立体模型,模拟经皮肾镜碎石术在虚拟仿真手术和常规手术的效果。为临床教学和科研提供方法,为年轻医生快速缩短手术学习时间。方法随机选取2017年12月~2019年2月北京房山区良乡医院就诊的30例肾结石患者作为试验组,对照组是同期在该院进行体检的正常人30例。两组采集肾脏CT扫描数据,利用Mimics16.0软件通过图像分割和融合重建肾脏的三维立体模型;记录虚拟仿真手术的穿刺肾盏、穿刺点、穿刺深度和选择通道等观察指标,记录总住院时间、平均手术时间、平均出血量、平均术后住院时间及术后并发症的发生率。结果虚拟仿真手术与实际手术的穿刺点符合度为100%,两组平均住院时间差异无统计学意义(P>0.05);两组间平均出血量、平均术后住院时间及并发症发生率差异均有统计学意义(P<0.05),虚拟仿真手术平均出血量减少,平均术后住院时间缩短,发症发生率降低。结论虚拟仿真手术可实现肾结石患者的个体化术前评估和手术设计,为临床医生准确地诊断和治疗提供依据。Objective To provide method for clinical teaching and research,for young doctors to quickly shorten the surgical learning time,a three-dimensional model of the kidney was reconstructed to simulate the effect of percutaneous nephrolithotripsy in virtual and conventional surgery.Methods A total of 30 patients with kidney stones treated in Liangxiang Hospital in Fangshan District of Beijing from December 2017 to February 2019 were randomly selected as the experimental group,while the control group was 30 normal subjects who underwent physical examination in same hospital during the same period.After collecting CT scan data of the two groups of patients,Mimics 16.0 was used.The software was used for image segmentation and fusion to reconstruct the three-dimensional model of the kidney.Observation indexes such as calix puncture,puncture point,puncture depth and channel selection were recorded in the virtual simulation operation.Total hospital stay,average operation time,average amount of blood loss,average postoperative hospital stay and incidence of postoperative complications were recorded.Results Virtual surgery simulation and the actual operation of the puncture point conformity degree was 100%.There was no significant difference of the average length of hospital stay between the two groups(P>0.05).The average blood loss,the average length of hospital stay and postoperative complications between the two groups were statistically significant(P<0.05).The virtual simulation surgery average blood loss reduced,the average postoperative hospital stay shortened,and the incidence of symptoms decreased.Conclusion Virtual simulation surgery can realize individualized preoperative evaluation and surgical design of kidney stone patients,and provide accurate diagnosis and treatment basis for clinicians.

关 键 词：肾结石 三维重建 虚拟仿真手术 经皮肾镜碎石术 人 

分 类 号：R699.2[医药卫生—泌尿科学]