腹腔镜下吲哚菁绿荧光显像联合术中超声引导肝血管瘤微波消融的初步探索  

Intial exploration of laparoscopic indocyanine green fluorescence imaging combined with intraoperative ultrasound-guided microwave ablation for hepatic hemangioma

作　　者：熊俊[1] 李民 唐勇 万赤丹 Xiong Jun;Li Min;Tang Yong;Wan Chidan(Department of Hepatobiliary Surgery,Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei Wuhan 430022, China)

机构地区：[1]华中科技大学同济医学院附属协和医院肝胆外科,湖北武汉430022

出　　处：《腹部外科》2020年第3期200-203,共4页Journal of Abdominal Surgery

摘　　要：目的探索腹腔镜下吲哚菁绿(indocyanine green,ICG)荧光显像联合术中超声引导的微波消融在肝血管瘤治疗中的应用价值和安全性评价。方法回顾性分析2017年1月至2019年12月于华中科技大学同济医学院附属协和医院接受ICG荧光显像联合术中超声引导腹腔镜下微波消融治疗的27例肝血管瘤病人的临床资料,分析消融手术时间、术中出血量以及围手术期并发症等。结果27例病人共血管瘤病灶53个,其中浅表病灶31个,深部病灶22个。所有病例均成功完成腹腔镜下肝血管瘤微波消融,无中转开腹,消融手术时间为(25.0±5.0)min,单枚病灶消融时间为(7.5±2.5)min,术中出血量为(30±5)ml,术后住院时间为(3.0±1.5)d。术后血红蛋白尿5例,术后发热3例,无术后肾功能不全、出血病例。结论ICG荧光显像联合术中超声引导可提高腹腔镜下肝血管瘤微波消融的精准性,减少并发症的发生,具有潜在的临床应用价值。Objective To explore the application and safety evaluation of laparoscopic indocyanine green(ICG)fluorescence imaging combined with intraoperative ultrasound-guided microwave ablation of hepatic hemangioma.Methods The retrospective study was conducted between January 2017 and December 2019 on 27 patients with hepatic hemangioma who underwent laparoscopic macrowave ablation using ICG fluorescence imaging combined with intraoperative ultrasound guidance at Union Hospital,to analyze ablation time,intraoperative blood loss and perioperative complications,etc.Results Of 27 patients with hepatic hemangioma,53 lesions were detected,including 31 subcapsular lesions and 22 intrahepatic lesions.The laparoscopic hepatic hemangioma microwave ablation for all patients were successfully performed without conversion to laparotomy.The average ablation time was(25.0±5.0)min and the average ablation time for a single lesion was(7.5±2.5)min.The intraoperative blood loss was(30±5)ml.The mean postoperative hospital stay was(3.0±1.5)days.Five patients developed postoperative hemoglobinuria and three patients postoperative pyrexia.There was no postoperative renal insufficiency and bleeding.Conclusion The ICG fluorescence imaging combined with intraoperative ultrasound-guidance can improve the accuracy and reduce complications of laparoscopic microwave ablation of hepatic hemangioma,which possesses potential clinical application value.

关 键 词：肝血管瘤 微波消融 吲哚菁绿 荧光显像 术中超声 

分 类 号：R619.9[医药卫生—外科学]