计算机辅助手术系统(Hisense CAS)在小儿漏斗胸NUSS术中的应用
Computer Aided Surgery System (Hisense CAS) Application in NUSS Operation of Infundibular Chest in Children
DOI: 10.12677/ACM.2024.142553, PDF,   
作者: 石佳宁, 李富江, 周显军, 段于河, 邢茂青*:青岛大学附属医院小儿外科,山东 青岛;王菲菲:山东省数字医学与计算机辅助外科重点实验室,山东 青岛;董 蒨*:青岛大学附属医院小儿外科,山东 青岛;山东省数字医学与计算机辅助外科重点实验室,山东 青岛
关键词: 计算机辅助手术系统不对称漏斗胸儿童NUSS手术Computer Aided Surgery System Asymmetrical Funnel Chest Children NUSS Operation
摘要: 目的:探讨海信计算机辅助手术系统(Hisense CAS)在小儿漏斗胸NUSS术中的应用及临床意义。方法:收集2019年1月至2023年10月青岛大学医学院附属医院收治的42例不对称漏斗胸患儿的临床资料,按照手术方式的不同将患儿分为CAS手术组(n = 21,应用CAS系统对其胸部CT数据进行三维重建)与常规手术组(n = 21,未应用CAS系统指导手术)。对比分析两组手术效果。结果:两组年龄、性别、术中出血量[(5.5 ± 1.4) ml vs (5.8 ± 1.7) ml]差异无统计学意义(P > 0.05)。CAS手术组与常规手术组手术时间[(44.2 ± 3.3) min vs (52.1 ± 7.3) min, P = 0.01]、手术优良率[(90.48%) vs (76.20%), P = 0.02]、术后并发症发生率[(4.76%) vs (28.57%), P = 0.04]差异均有统计学意义。结论:CAS系统有助于提高小儿外科医生对患儿个体胸壁及心肺解剖的认识,辅助设计NUSS手术个性化方案,可提高手术的准确性、安全性,减少手术时间,降低术后并发症,提高手术满意度,具有较高的临床应用价值。
Abstract: Objective: To investigate the application and clinical significance of Hisense CAS in NUSS of infun-dibular chest in children. Methods: Clinical data of 42 children with asymmetric infundibular chest admitted to the Affiliated Hospital of Qingdao University Medical College from January 2019 to Oc-tober 2023 were collected. According to different surgical methods, the children were divided into CAS surgery group (n = 21, three-dimensional reconstruction of chest CT data was performed by CAS system) and conventional surgery group (n = 21, the CAS system was not used to guide surgery). The operation effect of the two groups was compared and analyzed. Results: There was no signifi-cant difference in age, gender and intraoperative blood loss [(5.5 ± 1.4) ml vs (5.8 ± 1.7) ml] be-tween the two groups (P > 0.05). Operation time [(44.2 ± 3.3) min vs (52.1 ± 7.3) min, P = 0.01], surgical excellence rate [(90.48%) vs (76.20%), P = 0.02], incidence of postoperative complications [(4.76%) vs (28.57%) between CAS surgery group and conventional surgery group, P = 0.04]. The differences were statistically significant. Conclusion: CAS system is helpful for pediatric surgeons to improve their understanding of the chest wall and cardiopulmonary anatomy of individual children, and assist in the design of NUSS surgical personalized plan, which can improve the accuracy and safety of surgery, reduce the operation time, reduce postoperative complications, and improve the satisfaction of surgery, and has high clinical application value.
文章引用:石佳宁, 王菲菲, 李富江, 周显军, 段于河, 董蒨, 邢茂青. 计算机辅助手术系统(Hisense CAS)在小儿漏斗胸NUSS术中的应用[J]. 临床医学进展, 2024, 14(2): 3970-3978. https://doi.org/10.12677/ACM.2024.142553

参考文献

[1] 吴春东. 64排螺旋CT三维重建技术对胸部外伤的诊断价值[J]. 中国社区医师, 2021, 37(15): 128-129.
[2] 白洁, 闫天生. Nuss微创手术治疗漏斗胸的现状及进展[J]. 中国微创外科杂志, 2015, 15(8): 752-754.
[3] 谢亮, 陈刚. Nuss手术是目前漏斗胸治疗的主流术式[J]. 循证医学, 2014, 14(5): 261-263.
[4] 王学军, 徐冰, 刘文英, 等. Nuss微创漏斗胸矫形术后并发症及其处理[J]. 中国修复重建外科杂志, 2009(11): 1343-1346.
[5] 范晓晓. 大龄儿童漏斗胸手术治疗的个性化策略选择[D]: [硕士学位论文]. 济南: 山东大学, 2023.
[6] Dong, Q., Chen, Y.J., Lu, Y., et al. (2013) Developments and Clinical Applications of Digital Medicine and Computer-Assisted Operations. e-Healthcare, 9, 58-61.
[7] Nuss, D., Kelly, R.E., Croitoru, D.P., et al. (1998) A 10-Year Review of a Minimally In-vasive Technique for the Correction of Pectus Excavatum. Journal of Pediatric Surgery, 33, 545-552. [Google Scholar] [CrossRef
[8] Haller, J.A. and Turner, C.S. (1981) Diagnosis and Opera-tive Management of Chest Wall Deformities in Children. Surgical Clinics of North America, 61, 1199-1207. [Google Scholar] [CrossRef
[9] Kelly Jr., R.E., Obermeyer, R.J., Goretsky, M.J., et al. (2022) Recent Modifications of the Nuss Procedure: The Pursuit of Safety during the Minimally Invasive Repair of Pectus Ex-cavatum. Annals of Surgery, 275, e496-e502. [Google Scholar] [CrossRef
[10] 尚华. CT量化评估漏斗胸NUSS矫形术对胸廓的影响[D]: [硕士学位论文]. 郑州: 郑州大学, 2020.[CrossRef
[11] Anbarasu, C.R., Mehl, S.C., Sun, R.C., et al. (2022) Variations in Nuss Procedure Operative Techniques and Complications: A Retrospective Review. European Journal of Pediatric Surgery, 32, 357-362. [Google Scholar] [CrossRef] [PubMed]
[12] Papp, L., Juhasz, R., Travar, S., et al. (2010) Automatic Detection and Characterization of Funnel Chest Based on Spiral CT. Journal of X-Ray Science and Technology, 18, 137-144. [Google Scholar] [CrossRef
[13] Kim, H.C., Park, H., Nam, K.W., et al. (2010) Fully Automatic Ini-tialization Method for Quantitative Assessment of Chest-Wall Deformity in Funnel Chest Patients. Medical & Biological Engineering & Computing, 48, 589-595. [Google Scholar] [CrossRef] [PubMed]
[14] Scott, E., Fred, R., Karen, W., et al. (2000) Is the Grass Greener? Early Results of Nuss Procedure. Journal of Pediatric Surgery, 35, 246-251. [Google Scholar] [CrossRef
[15] 朱荣坤, 张虹, 荆晓英, 怀婵娟, 董蒨, 杨传民. 计算机辅助手术系统在小儿重复肾精准手术中的应用[J]. 临床小儿外科杂志, 2019, 18(2): 118-123.
[16] Aseni, P., Santaniello, T. and Rizzetto, F. (2021) Hybrid Additive Fabrication of a Transparent Liver with Biosimilar Haptic Re-sponse for Preoperative Planning. Diagnostics (Basel), 11, 1734. [Google Scholar] [CrossRef] [PubMed]
[17] 董蒨, 陈永健, 卢云, 等. 数字医学与计算机辅助手术的发展及临床应用[J]. 中国信息界-e医疗, 2013(9): 58-61.
[18] 董蒨, 周显军. 计算机辅助手术系统指导小儿肝脏肿瘤精准手术[J]. 临床小儿外科杂志, 2017, 16(6): 533-536.