实用医学杂志 ›› 2021, Vol. 37 ›› Issue (8): 1046-1050.doi: 10.3969/j.issn.1006⁃5725.2021.08.016

• 临床研究 • 上一篇    下一篇

老年肺癌合并肺结核患者胸腔镜肺癌根治术中三维重建技术的应用价值

盛健, 戴希勇,刘小玉, 蒋钰辉, 王冰, 刘奇斌, 姚利, 柳梅   

  1. 1 武汉市肺科医院外科(武汉 430083);2 武汉市中西医结合医院重症医学科(武汉 430022)

  • 出版日期:2021-04-25 发布日期:2021-04-25
  • 通讯作者: 戴希勇 E⁃mail:wuliming702@163.com
  • 基金资助:

    湖北省科技计划项目(编号:2018CFB353)

Application value of three ⁃ dimensional reconstruction technology in thoracoscopic radical resection for lung cancer in the elderly patients with lung cancer and tuberculosis

SHENG JianDAI XiyongLIU XiaoyuJIANG YuhuiWANG BingLIU QibinYAO LiLIU Mei.    

  1. Department of SurgeryWuhan Pulmonary HospitalWuhan 430083China
  • Online:2021-04-25 Published:2021-04-25
  • Contact: DAI Xiyong E⁃mail:wuliming702@163.com

摘要:

目的 探讨老年肺癌合并肺结核患者胸腔镜肺癌根治术中三维重建技术的应用价值。方法 回顾性分析 2015 8 月至 2019 10 月本院 80 例行胸腔镜肺癌根治术的老年肺癌合并肺结核患者,将采用三维重建及虚拟手术规划制定并实施手术的患者 41 例纳入 A 组,按照常规实施手术的患者 39 例纳入 B 组,比较两组手术情况。结果 三维重建显示分叶征、棘突征、血管集束征、短毛刺征、胸膜凹陷征征象比例高于轴位成像(P < 0.05);三维重建对淋巴结转移判定准确度、敏感度、特异度分别为: 87.80%、93.10%、75.00%,高于轴位成像 70.00%、75.00%、58.33%;A 组患者手术时间、术后住院时间短于 B 组,术中出血量、术后引流量少于 B 组,术中清扫淋巴结个数多于 B 组(P < 0.05);A 组并发症发生率 9.76% 低于 B 组(26.83%)(P < 0.05)。结论 老年肺癌合并肺结核患者胸腔镜肺癌根治术中三维重建技术的应 用可有效提供患者病灶信息,有利于减少手术时间,降低术中出血量,避免术后并发症的发生。

关键词:

Abstract:

Objective To explore application value of three ⁃ dimensional reconstruction technology in thoracoscopic radical resection for lung cancer in the elderly patients with lung cancer and tuberculosis. Methods A retrospective analysis was performed on 80 elderly patients with lung cancer and tuberculosis who had undergone thoracoscopic radical resection for lung cancer in our hospital from August 2015 to October 2019. Forty ⁃one patients receiving surgical procedures based on three⁃dimensional reconstruction and virtual surgery were assigned to group A,while another thirty⁃nine patients undergoing routine surgery were assigned to group B. The surgical situation was compared between the two groups. Results The proportions of lobular sign,spinous process sign vascular convergence sign,short burr sign and pleural depression sign displayed by three⁃dimensional reconstruction imaging were greater than those by axial imaging(P < 0.05). The accuracy,sensitivity and specificity of three⁃ dimensional reconstruction for determining lymph node metastasis were 87.80%,93.10% and 75.00%,which were higher than those of axial imaging(70.00%,75.00%,and 58.33%). The surgical duration and postoperative hospital stay were shorter,intraoperative blood loss and postoperative drainage volume were lower,and number of intraoper⁃ ative resected lymph nodes was larger(P < 0.05),and the incidence of complications was lower in group A than in group B(9.76% vs. 26.83%,P < 0.05). Conclusions Application of three⁃dimensional reconstruction technology in thoracoscopic radical resection for lung cancer in the elderly patients with lung cancer and tuberculosis can effectively provide lesion information,which is beneficial to shortening surgical duration,reducing intraoperative blood loss,and lowering occurrence of postoperative complications.

Key words:

thoracoscopic radical resection for lung cancer, three ?dimensional reconstruction technology, surgical duration, intraoperative blood loss