计算机辅助设计修饰3D打印模型用于早期肺癌胸腔镜亚肺叶切除术的回顾性队列研究  

Application of computer-aided design modified 3D printing model in video-assisted thoracoscopic sublobular resection for early lung cancer:A retrospective cohort study

作　　者：张欣宇 李林倩 李浩然 郭强[1,5] 闫红丽[4,5] 李靖华 程树杰[4,5] 李鹤飞 张珂[1,3,4,5] 杨季红 武建国[4] ZHANG Xinyu;LI Linqian;LI Haoran;GUO Qiang;YAN Hongli;LI Jinghua;CHENG Shujie;LI Hefei;ZHANG Ke;YANG Jihong;WU Jianguo(Department of Thoracic Surgery,Affiliated Hospital of Hebei University,Baoding,071000,Hebei,P.R.China;Department of Medicine,Hebei University,Baoding,071000,Hebei,P.R.China;3D Image and 3D Printing Center,Affiliated Hospital of Hebei University,Baoding,071000,Hebei,P.R.China;Basic Research Key Laboratory of General Surgery for Digital Medicine,Baoding,071000,Hebei,P.R.China;Institute of Life Science and Green Development,Hebei University,Baoding,071000,Hebei,P.R.China)

机构地区：[1]河北大学附属医院胸外科,河北保定071000 [2]河北大学医学部,河北保定071000 [3]河北大学附属医院3D医学影像打印中心,河北保定071000 [4]河北省普外科数字医学基础研究重点实验室,河北保定071000 [5]河北大学生命科学与绿色发展研究所,河北保定071000

出　　处：《中国胸心血管外科临床杂志》2024年第9期1266-1273,共8页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：河北省重点研发计划项目(19277731D);河北省政府资助专科能力建设和临床医学优秀人才培养项目;河北省2020年老年病防治项目;河北大学附属医院重点科研基金项目。

摘　　要：目的比较三维可视化(three-dimensional visual,3DV)模型、三维打印(three-dimensional printing,3DP)模型和计算机辅助设计(computer-aided design,CAD)修饰的3DP模型在电视辅助胸腔镜手术(video-assisted thoracoscopic surgery,VATS)亚肺叶切除中的应用效果。方法回顾性分析2021年11月—2022年8月于河北大学附属医院行VATS亚肺叶切除患者的临床资料。根据使用的辅助工具,将患者分为3DV组、3DP组和CAD-3DP组。比较3组患者的围术期资料、术者及家属的主观评价。结果共纳入22例患者,其中男5例、女17例,年龄32~77(56.95±12.50)岁。3DV组9例,3DP组6例,CAD-3DP组7例。3组患者的手术时间、术中出血量、引流量、住院时间及术后并发症等差异均无统计学意义(P>0.05)。在4名术者的7项主观评价中,CAD-3DP组在术前规划效率(P=0.025)、直观性(P=0.045)和医患沟通难易度(P=0.034)方面优于3DV组;在整体满意度(P=0.023)、术前规划难易度(P=0.046)和效率(P=0.014)方面优于3DP组。而患者及家属的7项主观评价中CAD-3DP组在帮助了解肿瘤周围脉管(P=0.016)、手术步骤(P=0.020)、方案选择(P=0.029)和整体满意度(P=0.048)方面优于3DP组;在帮助了解肿瘤大小(P=0.038)方面优于3DV组。结论CAD修饰的3DP模型在VATS亚肺叶切除术前规划、术中导航及医患沟通中有一定优势。Objective To compare the effect of three-dimensional visual(3DV)model,three-dimensional printing(3DP)model and computer-aided design(CAD)modified 3DP model in video-assisted thoracoscopic surgery(VATS)sublobular resection.Methods The clinical data of patients who underwent VATS sublobular resection in the Affiliated Hospital of Hebei University from November 2021 to August 2022 were retrospectively analyzed.The patients were divided into 3 groups including a 3DV group,a 3DP group and a CAD-3DP group according to the tools used.The perioperative indexes and subjective evaluation of operators,patients and their families were compared.Results A total of 22 patients were included.There were 5 males and 17 females aged 32-77(56.95±12.50)years.There were 9 patients in the 3DV group,6 patients in the 3DP group,and 7 patients in the CAD-3DP group.There was no statistical difference in the operation time,intraoperative blood loss,drainage volume,hospital stay time or postoperative complications among the groups(P>0.05).Based on the subjective evaluations of 4 surgeons,the CAD-3DP group was better than the 3DV group in the preoperative planning efficiency(P=0.025),intuitiveness(P=0.045)and doctor-patient communication difficulty(P=0.034);the CAD-3DP group was also better than the 3DP group in the overall satisfaction(P=0.023),preoperative planning difficulty(P=0.046)and efficiency(P=0.014).Based on the subjective evaluations of patients and their families,the CAD-3DP group was better than the 3DP group in helping understand the vessel around the tumor(P=0.016),surgical procedure(P=0.020),procedure selection(P=0.029),and overall satisfaction(P=0.048);the CAD-3DP group was better than the 3DV group in helping understand the tumor size(P=0.038).Conclusion CAD-modified 3DP model has certain advantages in pre-planning,intraoperative navigation and doctor-patient communication in the VATS sublobectomy.

关 键 词：计算机辅助设计 电视辅助胸腔镜手术 3D打印 亚肺叶切除 

分 类 号：R734.2[医药卫生—肿瘤]