ct三维重建在肾肿瘤腹腔镜肾部分切除术的应用分析word格式论文.docxVIP

优秀毕业论文 精品参考文献资料 中 文 摘 要 目的 利用多容积动态 CT 或多排螺旋 CT 影像及数字医学三维重建技术， 以泌尿外科诊治的肾肿瘤患者为研究对象，探讨其对于肾肿瘤临床分期的评估， 进行术前规划与设计，为指导腹腔镜下肾部分切除术提供确切可行的技术手段。 方法 1.选取我院 2012 年 9 月 1 日-2014 年 12 月 31 日初步诊断为肾肿瘤 的住院患者，行腹部 CT 平扫+增强检查，并以同期在我院未行三维重建的同等 例数患者为对照。2.将 CT 影像数据集导入三维重建软件 MIMICS 10.01 进行图 像三维重建，构建肾癌三维模型。3.根据肾肿瘤的三维重建模型作为临床分期 参考和手术定位与规划，并指导手术操作。4.记录手术数据及查询术后病理结 果，评估手术完成质量，评价三维重建技术对于肾肿瘤的诊断与腹腔镜肾部分 切除术的意义。 结果 本研究共建立三维重建模型59例，与大体病理对临床分期的符合度为 100%，且三维模型均能对解剖结构正确成像。通过三维模型辅助完成腹腔镜肾部 分切除术16例，术中实际操作角度为41.86±5.86°，手术时间为123.94± 15.76min，出血量56.94±37.62ml，肾动脉阻断时间为22.69±5.38min，术后住 院天数为8.06±1.24d，术中病理切缘无肿瘤细胞残留。 结论 CT 三维重建肾肿瘤模型能够确切立体地反映肾脏和肿瘤的三维形 态、肿瘤大小、毗邻组织、血管分支。为肾肿瘤的诊疗的选择和腹腔镜肾部分切 除术操作的提供精确参考。有利于精准外科手术的开展和实施，对临床中术前评 估和设定手术方式具有良好的参考意义，同时对于年轻外科医生学习理解肾癌的 病理解剖及手术操作有帮助意义。 关键词 影像；数字医学；三维重建；肾肿瘤；腹腔镜肾部分切除术；精 准外科手术 I Abstract Objective Using CT imaging and digital medicine 3D reconstruction techniques to the Urology diagnosis and treatment of renal tumor patients for the study, to investigate the assessment of the renal tumor staging, to plan for the operation and provide practical techniques. Methods 1.Select the patients whom were preliminary diagnosed with the renal tumor in our hospital from January 1, 2012 to December 31, 2014 to finish Abdominal CT examination. Meanwhile, select the same number patients that didn’t construct 3D reconstruction. 2.Make the abdominal urinary CT image data sets into the 3D reconstruction software MIMICS 10.01 for image reconstruction to construct a three-dimensional model of the integration of renal tumors. 3.Diagnosed, positioned, maked the operation planning and guided the operation through the model of 3D reconstruction of renal tumor. 4. Recorded operation data and queried results of pathology. Assessment the quality of operation. Evaluated three-dimensional reconstruction technique in the diagnosis and LPN for the significance of renal tumor resection. Results 59 model of 3D reconstruction had been established and 16 cases of LPN had been finished assisted by 3D mode