三维可视化技术在胸骨肿瘤切除和胸壁重建中的应用  

Application of 3D visualization technology in sternal tumor resection and chest wall reconstruction

作　　者：黄晓锋 单一波 糜烨东 虞桂平 HUANG Xiaofeng;SHAN Yibo;MI Yedong;YU Guiping(Dept.of Cardiothoracic Surgery,Jiangyin Clinical College of Xuzhou Medical University,Jiangyin 214400,Jiangsu,China)

机构地区：[1]徐州医科大学江阴临床学院胸心外科,江苏江阴214400

出　　处：《武汉大学学报（医学版）》2023年第7期829-832,共4页Medical Journal of Wuhan University

基　　金：吴阶平医学基金会临床科研专项资助基金(编号:320.6750.2020.10.45);江苏省卫生健康委科研项目(编号:M2020076);无锡市卫生健康委员会卫生科研青年项目(编号:Q202156)。

摘　　要：目的:探讨三维可视化技术在使用钛板及模块化假体进行胸骨重建的临床效果。方法:回顾性分析了2013年6月至2019年12月,在徐州医科大学江阴临床学院胸心外科施行了根治性切除的10例胸骨肿瘤病例,10例患者术前均行常规CT检查及三维可视化重建,其中6例病例使用钛板进行胸骨重建,4例病例使用模块化假体进行胸骨重建。结果:10例患者手术均顺利完成,围手术期间1例患者出现较严重的肺部感染,予以对症治疗后治愈,余患者无明显手术并发症。术后病理结果显示浆细胞瘤2例,软骨肉瘤4例,胸骨及周围软组织转移性甲状腺滤泡性癌1例,恶性纤维组织细胞瘤1例,软骨母细胞瘤1例,骨肉瘤1例。10例患者随访期为60个月;2例软骨肉瘤患者复发死亡,生存期分别为10个月及30个月;1例浆细胞瘤患者因多发转移死亡,生存期为28个月;1例软骨肉瘤患者因其他原因死亡,生存期为40个月;余患者未见复发,状况良好。结论:三维可视化技术在胸骨肿瘤切除及胸骨重建的术前评估和术中操作中有极大的指导作用,具有广泛的应用前景。Objective:To investigate the clinical effect of 3D visualization technique in sternal reconstruc⁃tion with titanium plate and modular prosthesis.Methods:Retrospective analysis was performed on 10 cases of sternal tumor that underwent radical resection from June 2013 to December 2019,in the Department of Cardiothoracic Surgery,Jiangyin Clinical College of Xuzhou Medical University.All of the 10 patients received conventional CT examination and 3D visualization reconstruction before surgery,and among the 10 cases,6 were treated with titanium plate for sternal reconstruction and 4 were treated with modular prosthesis for sternal reconstruction.Results:All the patients received suc⁃cessful operation.One patient developed severe pulmonary infection and was cured after symptomatic treatment.No obvious surgical complications were found in the other patients.Postoperative patho⁃logical diagnosis included plasmacytoma(2 cases),chondrosarcoma(4 cases),metastatic thyroid follic⁃ular carcinoma of sternum and surrounding soft tissue(1 case),malignant fibrous histiocytoma(1 case),chondroblastoma(1 case),and osteosarcoma(1 case).The follow⁃up period was 60 months.Two patients with chondrosarcoma relapsed and died,and their survival period was 10 months and 30 months respectively.One patient with plasmacytoma died with multiple metastases,and the survival period was 28 months.One patient with chondrosarcoma died due to other reasons,and the survival period was 40 months.Conclusion:3D visualization technology has a great guiding role in the preop⁃erative evaluation and intraoperative operation of sternal tumor resection and sternal reconstruction,and has a wide application prospect.

关 键 词：三维可视化技术 胸骨肿瘤 钛板 模块化假体 胸壁重建 

分 类 号：R655.1[医药卫生—外科学]