Mimics软件系统行三维重建指导胸腔镜下解剖性肺段切除术的临床应用分析  

Clinical application of Mimics software system to three-dimensional reconstruction to guide thoracoscopic anatomic pulmonary segmentectomy

作　　者：李爽 施益军[1] 丁国文[1] 孙扬永[1] 吕本博 刘建超 朱静峰[1] LI Shuang;SHI Yijun;DING Guowen;SUN Yangyong;LÜBenbo;LIU Jianchao;ZHU Jingfeng(Department of Cardiothoracic Surgery,Affiliated People's Hospital of Jiangsu University,Zhenjiang,212000,Jiangsu,P.R.China)

机构地区：[1]江苏大学附属人民医院心胸外科,江苏镇江212000

出　　处：《中国胸心血管外科临床杂志》2024年第1期59-64,共6页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：镇江市第六期169工程学术技术骨干科研项目(2021-169GG-27);江苏大学附属人民医院院级课题(Y2020002)。

摘　　要：目的探讨Mimics软件系统行三维计算机断层扫描支气管血管成像(three-dimensional computed tomography bronchography and angiography,3D-CTBA)指导胸腔镜下解剖性肺段切除术的临床效果。方法回顾性纳入2020年6月—2022年12月在江苏大学附属人民医院胸外科行胸腔镜肺段切除术患者,术前用交互式医学图像控制系统(Materiaise’s interactive medical image control system,Mimics)制作3D-CTBA的患者纳入观察组,未行3D-CTBA患者纳入对照组,比较两组患者的临床资料。结果共纳入59例患者,其中男29例、女30例,年龄25~79岁。观察组37例,对照组22例。观察组在手术时间[(163.0±48.7)min vs.(188.8±43.0)min,P=0.044]、术中出血量[10.0(10.0,20.0)mL vs.20.0(20.0,35.0)mL,P<0.001]以及术前穿刺定位率(5.4%vs.31.8%,P=0.019)优于对照组,差异有统计学意义。而胸腔引流管放置时间、胸腔引流量、术中闭合器钉仓使用个数、术后住院时间、术后肺漏气发生率差异无统计学意义(P>0.05)。结论对于需行解剖性肺段切除的患者,术前使用Mimics软件制作3D-CTBA有助于准确辨识肺动静脉解剖,缩短手术时间,减少术中出血量,有助于术前判断结节所在位置,减少术前有创定位,减轻患者痛苦,值得临床推广。Objective To investigate the clinical effect of 3D computed tomography bronchial bronchography and angiography(3D-CTBA)and guidance of thoracoscopic anatomic pulmonary segmentectomy by Mimics software system.Methods A retrospective analysis was performed on patients who underwent thoracoscopic segmentectomy in the Department of Thoracic Surgery of Affiliated People's Hospital of Jiangsu University from June 2020 to December 2022.The patients who underwent preoperative 3D-CTBA using Materiaise's interactive medical image control system(Mimics)were selected as an observation group,and the patients who did not receive 3D-CTBA were selected as a control group.The relevant clinical indicators were compared between the two groups.Results A total of 59 patients were included,including 29 males and 30 females,aged 25-79 years.There were 37 patients in the observation group,and 22 patients in the control group.The operation time(163.0±48.7 min vs.188.8±43.0 min,P=0.044),intraoperative blood loss[10.0(10.0,20.0)mL vs.20.0(20.0,35.0)mL,P<0.001],and preoperative puncture localization rate(5.4%vs.31.8%,P=0.019)in the observation group were better than those in the control group.There was no statistically significant difference in the thoracic tube placement time,thoracic fluid drainage volume,number of intraoperative closure nail bin,postoperative hospital stay,or postoperative air leakage incidence(P>0.05)between the two groups.Conclusion For patients who need to undergo anatomical pulmonary segmentectomy,using Mimics software to produce 3D-CTBA before surgery can help accurately identify pulmonary arteriovenous anatomy,reduce surgical time and intraoperative blood loss,help to determine the location of nodules and reduce invasive localization before surgery,and alleviate patients'pain,which is worthy of clinical promotion.

关 键 词：MIMICS软件 电视胸腔镜 三维重建 肺段切除术 早期肺癌 

分 类 号：R734.2[医药卫生—肿瘤]