三维重建技术结合三维打印技术在漏斗胸治疗中的应用。

IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Annals of Thoracic Medicine Pub Date : 2022-07-01 Epub Date: 2022-07-09 DOI:10.4103/atm.atm_506_21
Yibo Shan, Guiping Yu, Yi Lu, Hao Kong, Xuewei Jiang, Zhiming Shen, Fei Sun, Hongcan Shi
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引用次数: 0

摘要

目的:探讨三维(3D)重建技术结合3D打印技术治疗漏斗胸(PE)的临床价值。方法:回顾性分析2018年6月至2020年12月我科收治的10例PE患者的临床资料。所有患者术前均行薄层计算机断层扫描,然后用Mimics 20.0软件进行三维重建。根据重建图像设计胸肌杆的弧度和曲率。然后将图像以STL格式导入光固化3D打印机进行切片打印。因此,可以根据3D打印模型制定个性化的手术方案,包括胸肌棒的大小和手术入路。胸腔镜辅助下的Nuss手术通过双侧切口完成。统计分析手术时间、术中出血量、术后住院时间。根据Haller指数和最后侧胸骨压迫胸椎距离评价手术满意度。结果:10例患者均顺利完成手术,未转开腹手术。平均手术时间为(56±8.76)min,术中出血量为(23.5±11.07)mL,术后住院时间为(7.2±0.92)d,围手术期无严重并发症及死亡。与术前数据比较,最后侧胸骨受压胸椎距离增大,Haller指数降低,差异均有统计学意义(P < 0.05)。结论:3D重建技术与3D打印技术相结合,可在手术前应用,有助于术者安全有效地进行胸腔镜辅助下的Nuss手术,对治疗漏斗胸具有重要的临床应用价值。
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Application of three-dimensional reconstruction technology combined with three-dimensional printing in the treatment of pectus excavatum.

Objectives: To explore the clinical value of three-dimensional (3D) reconstruction technology combined with 3D printing in the treatment of pectus excavatum (PE).

Methods: The clinical data of 10 patients with PE in our department from June 2018 to December 2020 were analyzed retrospectively. All patients underwent thin-layer computed tomography examination before the operation, and then 3D reconstruction was performed with Mimics 20.0 software. The radian and curvature of the pectus bar were designed according to the reconstructed images. Afterward, the images were imported into the light-curing 3D printer in STL format for slice printing. Hence that the personalized operation scheme, including the size of the pectus bar and the surgical approach, can be made according to the 3D printed model. The thoracoscopic-assisted Nuss operation was completed by bilateral incisions. The operation time, intraoperative blood loss, and postoperative hospitalization were counted and analyzed. The satisfaction of the surgery was evaluated according to the Haller index and the most posterior sternal compression sternovertebral distance.

Results: The surgeries were successfully completed in 10 patients without a transfer to open procedure. The average operation time was (56 ± 8.76) min, the intraoperative blood loss was (23.5 ± 11.07) mL, and the postoperative hospitalization was (7.2 ± 0.92) d. There were no serious complications or death during the perioperative period. Compared with the data before the operation, the most posterior sternal compression sternovertebral distance was larger, and the Haller index was lower, the differences were statistically significant (P < 0.05).

Conclusions: 3D reconstruction technology combined with 3D printing, which can be used before operation, contributes to the operator performing thoracoscopic-assisted Nuss operation safely and effectively, which has productive clinical application value for the treatment of pectus excavatum.

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来源期刊
Annals of Thoracic Medicine
Annals of Thoracic Medicine CARDIAC & CARDIOVASCULAR SYSTEMS-RESPIRATORY SYSTEM
CiteScore
4.10
自引率
4.30%
发文量
19
审稿时长
>12 weeks
期刊介绍: The journal will cover studies related to multidisciplinary specialties of chest medicine, such as adult and pediatrics pulmonology, thoracic surgery, critical care medicine, respiratory care, transplantation, sleep medicine, related basic medical sciences, and more. The journal also features basic science, special reports, case reports, board review , and more. Editorials and communications to the editor that explore controversial issues and encourage further discussion by physicians dealing with chest medicine.
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