解剖学报 ›› 2021, Vol. 52 ›› Issue (4): 609-617.doi: 10.16098/j.issn.0529-1356.2021.04.016

• 人类学 • 上一篇    下一篇

虚拟仿真手术与常规手术对肾结石治疗效果的比较

武利兵1,2 高尚2 许阳阳3 王一丹3 和雨洁2 王海燕2 李筱贺2* 李志军2*   

  1. 1.北京市房山区良乡医院泌尿外科,北京 102446; 2.内蒙古医科大学基础医学院人体解剖学教研室,呼和浩特 010010; 3.内蒙古医科大学研究生院, 呼和浩特 010110
  • 收稿日期:2019-09-20 修回日期:2020-01-19 出版日期:2021-08-06 发布日期:2021-08-06
  • 通讯作者: 李筱贺;李志军 E-mail:798242742@qq.com
  • 基金资助:
    12-18岁正常及特发性脊柱侧凸胸腰段三维数字化临床解剖学研究;8-12岁青少年特发性脊柱侧凸三维数字化测量及生物力学研究

Comparison of the effect between virtual simulation operation and conventional operation for the treatment of kidney stones

WU Li-bing1,2 GAO Shang2 XU Yang-yang3 WANG Yi-dan3 HE Yu-jie2 WANG Hai-yan2 LI Xiao-he2* LI Zhi-jun2*   

  1. 1.Departmeng of Urinary Surgery, Liangxiang Hospital in Fangshan District, Beijing 102446,China; 2.Department of Anatomy,Basic Medical College,Inner Mongolia Medical University,Hohhot 010110, China; 3. Gradute School,Inner Mongolia Medical University, Hohhot 010110, China
  • Received:2019-09-20 Revised:2020-01-19 Online:2021-08-06 Published:2021-08-06
  • Contact: LI Xiao-he; LI Zhi-jun E-mail:798242742@qq.com

摘要:

目的  重建肾脏的三维立体模型,模拟经皮肾镜碎石术在虚拟仿真手术和常规手术的效果。为临床教学和科研提供方法,为年轻医生快速缩短手术学习时间。   方法  随机选取2017年12月~2019年2月北京房山区良乡医院就诊的30例肾结石患者作为试验组,对照组是同期在该院进行体检的正常人30例。两组采集肾脏CT扫描数据,利用Mimics16.0软件通过图像分割和融合重建肾脏的三维立体模型;记录虚拟仿真手术的穿刺肾盏、穿刺点、穿刺深度和选择通道等观察指标,记录总住院时间、平均手术时间、平均出血量、平均术后住院时间及术后并发症的发生率。   结果  虚拟仿真手术与实际手术的穿刺点符合度为100%,两组平均住院时间差异无统计学意义(P>0.05);两组间平均出血量、平均术后住院时间及并发症发生率差异均有统计学意义(P<0.05),虚拟仿真手术平均出血量减少,平均术后住院时间缩短,发症发生率降低。   结论  虚拟仿真手术可实现肾结石患者的个体化术前评估和手术设计,为临床医生准确地诊断和治疗提供依据。

关键词: 肾结石, 三维重建, 虚拟仿真手术, 经皮肾镜碎石术,

Abstract:

Objective  To provide method  for clinical teaching and research, for young doctors to quickly shorten the surgical learning time,a three-dimensional model of the kidney was reconstructed to simulate the effect of percutaneous nephrolithotripsy in virtual and conventional surgery.    Methods  A total of 30 patients with kidney stones treated in Liangxiang Hospital in Fangshan District of Beijing from December 2017 to February 2019 were randomly selected as the experimental group, while the control group was 30 normal subjects who underwent physical examination in same hospital during the same period. After collecting CT scan data of the two groups of patients, Mimics 16.0 was used. The software was used for image segmentation and fusion to reconstruct the threedimensional model of the kidney. Observation indexes such as calix puncture, puncture point, puncture depth and channel selection were recorded in the virtual simulation operation. Total hospital stay, average operation time, average amount of blood loss, average postoperative hospital stay and incidence of postoperative complications were recorded.    Results  Virtual surgery simulation and the actual operation of the puncture point conformity degree was 100%.There was no significant difference of the average length of hospital stay between the two groups (P>0.05). The average blood loss, the average length of hospital stay and  postoperative complications between the two groups were statistically significant (P<0.05). The virtual simulation surgery average blood loss reduced, the average postoperative hospital stay shortened, and the incidence of symptoms decreased.    Conclusion  Virtual simulation surgery can realize individualized preoperative evaluation and surgical design of kidney stone patients, and provide accurate diagnosis and treatment basis for clinicians.

Key words: Kidney stone, Three-dimensional reconstruction, Virtual simulation surgery, Percutaneous nephrolithotomy, Human

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