腹腔镜超声联合CT三维重建引导腹腔镜肝切除术  

Laparoscopic ultrasound combined with CT three-dimensional reconstruction for guiding laparoscopic hepatectomy

作　　者：王丹璞 赫嵘 贾哲 王米雪 何楠 张萌 张瑶 WANG Danpu;HE Rong;JIA Zhe;WANG Mixue;HE Nan;ZHANG Meng;ZHANG Yao(Department of General Surgery,2.Department of Ultrasound,3.Department of Radiology,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)

机构地区：[1]首都医科大学附属北京地坛医院普外科,北京100015 [2]首都医科大学附属北京地坛医院超声科,北京100015 [3]首都医科大学附属北京地坛医院放射科,北京100015

出　　处：《中国医学影像技术》2024年第2期172-176,共5页Chinese Journal of Medical Imaging Technology

基　　金：北京市属医院科研培育计划项目(PX2020069)。

摘　　要：目的观察腹腔镜超声(LUS)联合CT三维重建引导腹腔镜肝切除术(LH)的价值。方法回顾性分析78例接受LH的肝细胞癌(HCC)患者,根据是否接受术前CT三维重建及LUS分为观察组(n=46)或对照组(n=32);比较组间临床资料、围手术期资料及预后。结果组间临床资料差异均无统计学意义(P均>0.05),而肿瘤主体所在肝段、切除方式、肿瘤切缘、手术时间、术中出血量、术后住院时间、术后并发症分级及发生率差异均有统计学意义(P均<0.05)。随访期间观察组死亡15例,对照组死亡14例;组间无瘤生存率差异有统计学意义(χ^(2)=4.210,P=0.040)。结论LUS联合CT三维重建用于引导LH可降低术中损伤和并发症发生率、提高HCC患者无瘤生存率。Objective To observe the value of laparoscopic ultrasound(LUS)combined with CT three-dimensional reconstruction for guiding laparoscopic hepatectomy(LH).Methods Data of 78 hepatocellular carcinoma(HCC)patients who underwent LH were retrospectively analyzed.The patients were divided into observation group(n=46)or control group(n=32)based on whether underwent preoperative CT three-dimensional reconstruction and LUS.Clinical data,perioperative data and prognosis were compared between groups.Results No significant difference of clinical data was found(all P>0.05),whereas significant differences of tumor body mainly location,resection method,tumor resection margin,surgical operation time,intraoperative blood loss,postoperative hospital stay,postoperative complication grading and incidence were found between groups(all P<0.05).During follow-up period,15 patients died in observation group and 14 died in control group.Significant difference of disease-free survival rate was detected between groups(χ^(2)=4.210,P=0.040).Conclusion LUS combined with CT three-dimensional reconstruction for guiding LH could reduce intraoperative injury and complication incidence,improving disease-free survival rate of HCC patients.

关 键 词：癌 肝细胞 腹腔镜 肝切除术 超声检查 介入性 体层摄影术 X线计算机 成像 三维 

分 类 号：R735.7[医药卫生—肿瘤] R445[医药卫生—临床医学]