CT三维重建结合3D打印技术在肝癌切除手术治疗中的应用观察  

Application of CT three-dimensional reconstruction combined with 3D printing technology in liver cancer resection surgery

作　　者：陈健 李友伟[1] 刘余 李淼 李锋[1] 周禄科 杨洁 李晓东[1] 郑本波[1] CHEN Jian;LI Youwei;LIU Yu;LI Miao;LI Feng;ZHOU Luke;YANG Jie;LI Xiaodong;ZHENG Benbo(Department of Hepatobiliary Pancreatic Surgery,Deyang People's Hospital,Deyang 618000,China;不详)

机构地区：[1]德阳市人民医院肝胆胰外科,四川德阳618000 [2]四川华曙图灵增材制造技术有限责任公司,四川成都610213

出　　处：《山东医药》2025年第2期80-84,共5页Shandong Medical Journal

基　　金：四川省德阳市科技计划项目(2022SCZ132)。

摘　　要：目的分析CT三维重建结合3D打印技术在肝癌切除手术治疗中的应用效果。方法选择肝细胞癌患者80例,根据手术方案不同分为3D组38例、常规组42例。3D组于肝切除手术前采用CT三维重建结合3D打印技术进行手术规划和指导,常规组按传统手术规划,常规腹腔镜或开腹实施肝切除手术。比较两组手术操作时间、术中出血量、肝门阻断时间、住院时间以及虚拟与实际肝脏切除体积和残肝体积,病理切缘阴性率,手术前后肝功能[包括丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)及γ谷氨酰转移酶(γ-GT)],术后并发症以及术后1、2年肿瘤复发/转移率和术后1、2年生存率。结果3D组手术操作时间、术中出血量、肝门阻断时间均低于常规组,虚拟与实际残肝体积均高于常规组(P均<0.05);两组住院时间、虚拟与实际肝脏切除体积比较差异均无统计学意义(P均>0.05)。3D组术中病理切缘阴性率高于常规组(P<0.05)。3D组术后3、7 d血清ALT、AST、TBIL、γ-GT水平均低于常规组同期(P均<0.05)。两组术后并发症发生率比较无统计学意义(P>0.05)。两组术后1、2年肿瘤复发/转移率及术后1、2年生存率比较差异均无统计学意义(P均>0.05)。结论CT三维重建结合3D打印技术用于肝癌切除手术,可避免肿瘤残留,保护残余肝体积,减轻肝功能损伤。Objective To analyze the application effect of CT three-dimensional reconstruction combined with 3D printing technology in liver cancer resection surgery.Methods Eighty patients with hepatocellular carcinoma were se lected and divided into the 3D group of 38 cases and conventional group of 42 cases according to different surgical plans.In the 3D group,we used CT three-dimensional reconstruction combined with 3D printing technology for surgical planning and guidance before liver resection surgery,while in the conventional group,we performed liver resection surgery accord ing to traditional surgical planning,using laparoscopy or laparotomy.We compared the surgical operation time,intraopera tive blood loss,portal block time,hospital stay,virtual and actual liver resection volume and residual liver volume,the rate of pathologically negative margin,pre-and post-operative liver function[including alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),andγ-glutamyltransferase(γ-GT)],postoperative complica tions,as well as tumor recurrence/metastasis rate and survival rate at 1 and 2 years after surgery between two groups.Results The surgical operation time,intraoperative blood loss,and hepatic portal block time in the 3D group were lower than those in the conventional group,and the virtual and actual residual liver volume was higher than that in the conven tional group(all P<0.05).There was no statistically significant difference in hospitalization time or virtual and actual liver resection volume between the two groups(all P>0.05).The rate of pathologically negative margins in the 3D group was higher than that in the conventional group(P<0.05).The serum levels of ALT,AST,TBIL,andγ-GT in the 3D group were lower than those in the conventional group at 3 and 7 days after surgery(all P<0.05).There was no statistically sig nificant difference in the incidence of postoperative complications between the two groups(P>0.05).There were no statis tically significant differences in the tumor recurre

关 键 词：计算机体层扫描 三维重建技术 3D打印技术 肝肿瘤 肝癌 

分 类 号：R735.7[医药卫生—肿瘤]