| 董庆 曹守强 申宝忠 徐万海 崔键 李雅杰.基于医疗数据信息集成系统的3D打印技术在肺癌手术中的应用[J].,2016,16(3):457-460 |
| 基于医疗数据信息集成系统的3D打印技术在肺癌手术中的应用 |
| Application of 3D Printing Technology based on Medical Data InformationIntegration Systemin Lung Cancer Surgery |
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| DOI： |
| 中文关键词: 医院信息化 3D打印 电视胸腔镜手术 非小细胞肺癌 |
| 英文关键词: Hospital Information 3D printing Video-assisted Thoracoscopic Surgery Non-Small Cell Lung Cancer |
| 基金项目:国家高技术研究发展计划(863 计划)（
2012AA02A616）；国家高技术研究发展计划(863 计划)（
2012AA02A601）；
黑龙江省应用技术研究与开发计划项目（GA14C101） |
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| 中文摘要: |
| 目的：探讨基于医疗数据信息集成系统的3D打印技术在治疗肺癌中的应用。方法：2014 年10 月～ 2015 年10 月收治的符
合肺癌临床路径，进入医疗数据信息集成系统，并接受320排螺旋CT扫描三维重建，3D打印出实体1:1 大小的患侧肺血管及肺
病灶模型，术前制定手术方案且模拟手术过程的42 例非小细胞肺癌（NSCLC）患者，经电视胸腔镜应用内镜缝合切割器切除病
灶，术中快速冰冻切片明确诊断，行肺段切除术，肺叶切除术。观察术中肺血管与3D打印符合程度。记录手术时间、术中出血量、
切除淋巴结数量、有无术中死亡、病理结果、并发症、引流时间和引流量及术后生存情况。结果：术中证实95%以上的肺血管可被
3D打印出来。手术时间(51.4± 18.1) min，术中出血量(40.2± 20.3) mL。切除淋巴结(7.1± 2.8) 枚。无术中死亡。术后病理回报示
肺鳞癌13 例，肺腺癌29 例。病理分期：T1aN0M0 12 例，T1aN1M0 10 例，T1bN0M0 3 例，T1bN1M0 3 例，T2aN0M0 2 例，
T2aN1M0 12 例。术后患者无严重并发症，其中肺感染6 例、肺膨胀不全6 例、房颤5 例，所有患者经积极后痊愈；术后引流时间
(3.0± 1.2) d，引流量(200.7± 66.1) mL /d。42 例随访2 ～ 12 个月，中位随访时间8.0 月，40例无瘤生存，术后6 个月发生转移脑转
移2 例，分别于术后7 和10 个月死亡。结论：基于医疗数据信息集成系统的3D 打印技术可以应用于肺癌手术。 |
| 英文摘要: |
| Objective:To study the application of the 3D printing technology based on medical data information integration systemin
lung cancer surgery.Methods:Forty-two NSCLC patients were enrolled from October 2014 to October 2015, who were examined
with 320-row multi-detector computed tomography preoperatively. 3D printing model of 1:1 size was made according the ipsilateral pulmonary
vessels and pulmonary lesion. We would draw up a plan before surgery and simulate the operation procedure of 42 patients with
non small cell lung cancer (NSCLC) patients. The patients underwent segmentectomy or lobectomy was performed by VATS based on
fast frozen sections in operation. Observe the conformity between pulmonary vascular in surgery and that in 3D printing, then record operation
time, blood loss, number of lymph node, whether death, pathologic results, complications, the drainage time and flow and postoperative
survival situation.Results:It was confirmed that over 95%pulmonary vessel could be found by 3D printing during the operation.
Operation time was (51.4± 18.1) min, and the mean blood loss was (40.2± 20.3) mL. 7.1± 2.8 lymph nodes were resected. There was no
death during the operation. Postoperative pathology showed squamous cell cancer in 13 cases and adenocarcinoma in 29; Postoperative
pathological staging showed T1aN0M0 in 12 patients, T1aN1M0 in 10 patients, T1bN0M0 in 3 patients, T1bN1M0 in 3 patients,
T2aN0M0 in 2 patients, T2aN1M0 in 12 patients. 6 patients developed pulmonary infection, which were cured by anti-inflammatory and
6 patients with atelectasis were cured by vacuum aspiration. 5 patients with atrial fibrillation were cured by the injection of amiodarone
hydrochloride. There was no severe complication. The mean duration for chest drainage was (3.0± 1.2) d and the mean drainage volume
was (200.7± 66.1) mL/d. Follow-up period was 2 to 12 months in 42 patients. Forty patients survived without tumor. Two patients developed
brain metastasis after 6 months, who dead in 7 months and 10 months postoperatively respectively.Conclusion:3D printing based
on medical data information integration systemcould be applied in lung cancer surgery. |
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