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三维重建技术在胸腔镜手术中定位肺小结节的应用效果研究

Study on the Application Effect of Three-dimensional Reconstruction Technology in Locating Small Pulmonary Nodules During VATS Surgery.

作者信息

Zhao Jialai, Qu Mingyue, Xu Zigeng, Zhang Yiling, Ma Chenguang

出版信息

Altern Ther Health Med. 2025 Sep;31(5):180-185.

Abstract

OBJECTIVE

To compare the positioning effect of three-dimensional reconstruction technology and Hook-wire puncture operation on small pulmonary nodules during video-assisted thoracoscopic surgery (VATS), and evaluate its effectiveness, efficiency, and safety.

METHODS

The subjects of this study were 50 patients with small pulmonary nodules admitted to the Department of Cardiothoracic Surgery of Heilongjiang Provincial Hospital from January 2020 to December 2022, and all underwent thoracoscopic surgical resection. All study subjects met the inclusion criteria, grouping according to the intraoperative positioning method, the control group (n = 25) used Hook-wire puncture positioning, and the observation group (n = 25) used three-dimensional reconstruction technology. The positioning effect, pain level, and postoperative complications were compared between the two groups.

RESULTS

The incidence rate of complications after puncture was 16.00% in the control group and 4.00% in the observation group, the complication rate in the observation group was significantly lower; the positioning success rate of the observation group was 96.00%, which was higher than that of the control group (92.00%). The operation time (32.25±6.08) min was lower than (38.50±7.12) min in the control group. The two groups had no statistical significance in the wedge resection success rate, VAS score, and complication rate (P > .05).

CONCLUSION

Three-dimensional reconstruction technology mainly makes preliminary judgments on the location, shape, size, and relationship between nodules and surrounding tissues based on preoperative CT scan images. It can select suitable scanning locations, map puncture paths, and anchor them in and around small lung nodules. The operation is simple, and the positioning success rate is high. The existence of three-dimensional reconstruction technology to position the guide wire can quickly shorten the time to detect lesions, shorten the time of VATS, reduce the occurrence of pulmonary infection in patients, and improve the prognosis.

摘要

目的

比较三维重建技术与Hook-wire穿刺术在电视胸腔镜手术(VATS)中对小肺结节的定位效果,评价其有效性、效率及安全性。

方法

选取2020年1月至2022年12月在黑龙江省医院胸心外科住院的50例小肺结节患者,均行胸腔镜手术切除。所有研究对象均符合纳入标准,根据术中定位方法分组,对照组(n = 25)采用Hook-wire穿刺定位,观察组(n = 25)采用三维重建技术。比较两组的定位效果、疼痛程度及术后并发症。

结果

对照组穿刺后并发症发生率为16.00%,观察组为4.00%,观察组并发症发生率明显更低;观察组定位成功率为96.00%,高于对照组(92.00%)。手术时间(32.25±6.08)min低于对照组的(38.50±7.12)min。两组在楔形切除成功率、VAS评分及并发症发生率方面差异无统计学意义(P > 0.05)。

结论

三维重建技术主要基于术前CT扫描图像对结节的位置、形态、大小及与周围组织的关系做出初步判断,可选择合适的扫描位置,规划穿刺路径,并将其锚定在小肺结节内及周围。操作简便,定位成功率高。三维重建技术引导丝定位的存在可快速缩短病灶检测时间,缩短VATS时间,减少患者肺部感染的发生,改善预后。

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