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虚拟现实和 3D 打印在临床麻醉中的应用:单中心 2 年经验的病例系列

Virtual reality and 3D printing in clinical anesthesia: a case series of two years' experience in a single tertiary medical centre.

机构信息

Division of Anesthesia, Intensive Care, and Pain Management, Tel Aviv Medical Center, Tel Aviv University, 6 Weizmann St, Tel Aviv, Israel.

Levin Center for Surgical Innovation and 3D Printing, Tel Aviv Medical Center, Tel Aviv, Israel.

出版信息

Can J Anaesth. 2023 Sep;70(9):1433-1440. doi: 10.1007/s12630-023-02530-2. Epub 2023 Jul 27.

Abstract

PURPOSE

Anatomically correct patient-specific models made from medical imaging can be printed on a three-dimensional (3D) printer or turned into a virtual reality (VR) program. Until recently, use in anesthesia has been limited. In 2019, the anesthesia department at Tel Aviv Medical Center launched a 3D program with the aim of using 3D modelling to assist in preoperative anesthesia planning.

METHODS

A retrospective review of all relevant patients between July 2019 and June 2021 referred for preoperative airway planning with 3D modelling. Patient files were reviewed for correlation between the model-based airway plan and the actual airway plan, the type of model used, and any anesthetic complications related to airway management.

RESULTS

Twenty patients were referred for 3D modelling. Of these, 15 models were printed, including 12 children requiring one lung ventilation. Five patients had VR reconstructions, including three with mediastinal masses. One patient had both a 3D-printed model and a VR reconstruction. There were two cases (10%) where the model plan did not correlate with the final airway plan and one case where a model could not be created because of poor underlying imaging. For the remaining 17 cases, the plan devised on the model matched the final airway plan. There were no anesthetic complications.

CONCLUSIONS

Three-dimensional modelling and subsequent printing or VR reconstruction are feasible in clinical anesthesia. Its routine use for patients with challenging airway anatomy correlated well with the final clinical outcome in most cases. High-quality imaging is essential.

摘要

目的

使用医学成像制作的解剖学正确的患者特定模型可以通过三维(3D)打印机打印或转化为虚拟现实(VR)程序。直到最近,它在麻醉中的应用才受到限制。2019 年,特拉维夫医疗中心的麻醉科推出了一个 3D 项目,旨在使用 3D 建模来辅助术前麻醉计划。

方法

回顾性分析 2019 年 7 月至 2021 年 6 月期间因术前气道规划而使用 3D 建模的所有相关患者。对患者的档案进行审查,以确定模型为基础的气道计划与实际气道计划之间的相关性、所使用的模型类型以及与气道管理相关的任何麻醉并发症。

结果

有 20 名患者被推荐进行 3D 建模。其中,15 个模型被打印,包括 12 名需要单肺通气的儿童。5 名患者进行了 VR 重建,其中 3 名患者有纵隔肿块。1 名患者同时进行了 3D 打印模型和 VR 重建。有 2 例(10%)模型计划与最终气道计划不相关,1 例由于基础成像质量差而无法创建模型。对于其余的 17 例,模型上制定的计划与最终气道计划相符。没有发生麻醉并发症。

结论

3D 建模以及随后的打印或 VR 重建在临床麻醉中是可行的。在大多数情况下,对于具有挑战性气道解剖结构的患者,其常规使用与最终临床结果相关性良好。高质量的成像至关重要。

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