ICG示踪联合三维可视化技术指导下改良右半肝切除术治疗肝细胞癌的回顾性研究  

Retrospective study of modified right hemihepatectomy for hepatocellular carcinoma guided by ICG tracerand3Dvisualizationtechnique

作　　者：齐普良 田青山[2] 马丽娜 李彩霞[1] 阿吉德 Qi Puliang;Tian Qingshan;Ma Lina;Li Caixia;Ajid(Department of Emergency Surgery,the Affliated Hospital of Qinghai University,Xining Qinghai Province 810001,China;Department of Hepatobiliary Surgery,the Affliated Hospital of Qinghai University,Xining Qinghai Province 810001,China;Department of General Surgery,the Affliated Hospital of Qinghai University,Xining Qinghai Province 810001,China;Department of Emergency ICU,Qinghai Provincial People's Hospital,Xining Qinghai Province 810000,China)

机构地区：[1]青海省人民医院急诊外科,西宁810000 [2]青海省人民医院肝胆外科,西宁810000 [3]青海大学附属医院急诊ICU,西宁810000 [4]青海省人民医院普外科,西宁810000

出　　处：《中华普外科手术学杂志（电子版）》2023年第2期162-166,共5页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：2020年青海省卫生计生系统指导性计划课题(2020-WJZDX-27)。

摘　　要：目的:探讨吲哚菁绿(ICG)示踪联合三维可视化技术指导下改良右半肝切除术(MRH)治疗肝细胞癌(HCC)的临床效果。方法:回顾性分析2018年1月至2020年12月行MRH的92例HCC患者的临床资料,根据患者是否采用ICG示踪联合三维可视化技术指导分为传统组(n=50)和联合组(n=42)。传统组采用传统影像学评估行MRH,联合组采用ICG示踪联合三维可视化技术指导行MRH。数据应用软件SPSS 22.0处理,围手术期相关指标、肝功能指标等计量资料采用(xˉ±s)表示,肝功能指标行重复测量方差分析,其余均行独立样本t检验;术后并发症等计数资料行χ^(2)检验;生存分析采用Kaplan-Meier法并行Log-Rank检验。P<0.05为差异有统计学意义。结果:联合组手术时间、肝门阻断时间及术中出血量均显著低于传统组(P<0.05);时间与方法在白蛋白(ALB)、总胆红素(TBil)及谷丙转氨酶(ALT)水平上不存在交互作用(P>0.05),时间与方法在ALB、TBil、ALT水平上主效应显著(P<0.05)。联合组患者术后并发症的总发生率较传统组显著降低(11.9% vs. 30.0%,P<0.05)。随访期间,联合组的累积总生存率及无病生存率均显著高于传统组(P<0.05)。结论:ICG示踪联合三维可视化技术指导下MRH治疗HCC不仅可有效缩短手术时间,减少术中损伤,而且还有利于患者术后肝功能恢复,降低术后并发症发生,提高患者预后。Objective To investigate the clinical effect of improved right hemihepatectomy(MRH)in the treatment of hepatocellular carcinoma(HCC)under the guidance of indocyanine green(ICG)tracer and 3D visualization technology.Methods Clinical data of 92 patients with HCC who received MRH from January 2018 to December 2020 were retrospectively analyzed,and the patients were divided into traditional group(n=50)and combined group(n=42)according to whether they were guided by ICG tracer combined with 3D visualization technology.Conventional imaging was used to evaluate MRH in the traditional group,and ICG tracer combined with 3D visualization was used to guide MRH in the combined group.The data were processed by SPSS 22.0 software,and measurement data such as perioperative indicators and liver function indicators were represented by(x+s).Repeated measurement analysis of variance was performed for liver function indicators,and independent sample t test was performed for other indicators.The statistical data of postoperative complications were chi-square test.Survival analysis was performed by Kaplan-Meier method and Log-Rank test.P<0.05 was considered statistically significant.Results Operation time,hilar occlusion time and intraoperative blood loss in combination group were significantly lower than those in traditional group(P<0. 05). There was no interaction between time and method at albumin (ALB), total bilirubin (TBil) andalanine aminotransferase (ALT) levels (P>0. 05), but the main effect of time and method was significant atALB, TBil and ALT levels (P<0. 05). The total incidence of postoperative complications in the combinationgroup was significantly lower than that in the traditional group (11.9% us. 30. 0%, P<0.05). During thefollow-up period, the cumulative overall survival rate and disease-free survival rate of the combination groupwere significantly higher than those of the traditional group (P<0. 05). Conclusion The treatment of HCCwith MRH under the guidance of ICG tracer and 3D visualization technology can not onl

关 键 词：癌 肝细胞 肝切除术 吲哚菁绿 三维可视化技术 

分 类 号：R735.7[医药卫生—肿瘤]