吲哚青绿清除试验、SPECT和三维重建技术在原发性肝癌患者行半肝切除术中的应用  

Application of indocyanine green clearance test, single photon emission computed tomography and three-dimensional reconstruction in patients with primary liver cancer before hemihepatectomy

作　　者：栗雪峰 李建生 马金良 荚卫东 刘文斌 陈浩 

机构地区：[1]安徽医科大学附属省立医院肝脏外科/肝胆胰外科安徽省重点实验室,合肥市230001

出　　处：《实用肝脏病杂志》2017年第4期477-480,共4页Journal of Practical Hepatology

基　　金：国家自然科学基金资助项目(编号:81272398)

摘　　要：目的探讨联合吲哚青绿(ICG)清除试验、单光子发射型计算机断层显像(SPECT)和三维重建技术在术前评估原发性肝癌(PLC)患者行半肝切除手术中的应用价值。方法回顾分析50例行半肝切除术的PLC患者的临床资料,其中26例观察组术前行ICG清除试验、SPECT和三维重建技术联合术前评估,另24例对照组未行联合术前评估,比较两组患者术中和术后相关指标,分析术后出现肝功能不全或其他并发症的差异。结果观察组与对照组手术时间分别为(134.2±40.7)min对(157.0±33.2)min,术后住院日分别为(12.2±4.7)d和(14.8±3.4)d,差异显著(P<0.05),而两组术中失血量、拔管天数无显著相差(P>0.05);观察组术后胆漏、腹腔积液、肺部感染、切口感染和肝功能不全发生率显著低于对照组(P<0.05)。结论联合ICG清除试验、SPECT和三维重建技术术前评估肝功能和肿瘤情况对PLC患者行半肝切除术有一定的指导意义。Objective To explore the application of indocyanine green （ICG） clearance test,single photon emission computed tomography （SPECT ） and three-dimensional resconstruction in patients with primary liver cancer before hemihepatectomy. Methods Clinical data of 50 patients with PLC who had underwent hemihepatectomy were collected and analyzed. Among them,twenty-six patients underwent preoperative evaluation of ICG clearance test,SPECT and three-dimensional reconstruction technique before operation as observation group,and twenty-four didn＇t get the evaluation as the control. The operative and postoperative indicators in the two groups were compared,and the differences of postoperative liver dysfunction and other complications were analyzed. Results The operative times in the observation and control were （134.2±40.7）min and （157.0±33.2） min,hospitalization days after operation were （12.2±4.7） d and （14.8±3.4） d,respectively,with the differences significantly different （P〈0.05）,while the blood loss and tube drawing in the two groups were not significantly different （P〉0.05）;the incidence of postoperative complications,such as bile leakage,ascites,pulmonary infection, infection of incisional wound and liver deficiency in the observation group was 19.2%,significantly lower than that in the control group（45.8%,P〈0.05）. Conclusion The preoperative evaluation by ICG clearance test,SPECT and three-dimensional reconstruction is helpful in guiding hemihepatectomy in patients with PLC before operation.

关 键 词：原发性肝癌 半肝切除术 术前评估 肝功能不全 

分 类 号：R735.7[医药卫生—肿瘤]