三维可视化、荧光影像联合超声技术在外科治疗重度肝硬化相关性小肝癌定位中的应用效果  

The application effect of three-dimensional visualization technology,fluorescence imaging system combined with ultrasonography for surgery of small hepatocellular carcinoma associated with severe liver cirrhosis

作　　者：贺小军 白亮亮 杜锡林 HE Xiaojun;BAI Liangliang;DU Xilin(Department of General Surgery,the Second Affiliated Hospital of Air Force Medical University,Shaanxi Xi'an 710038,China.)

机构地区：[1]空军军医大学第二附属医院普通外科,陕西西安710038

出　　处：《现代肿瘤医学》2024年第6期1089-1093,共5页Journal of Modern Oncology

基　　金：陕西省自然科学基础研究计划(编号:2020JM-337)。

摘　　要：目的:分析联合三维可视化技术、吲哚菁绿荧光影像和超声技术在合并重度肝硬化小肝癌精准定位中的应用效果。方法:回顾性分析2019年01月至2022年12月我院普通外科行开腹和腹腔镜手术治疗合并重度肝硬化的63例小肝癌患者资料。在术中超声辅助的基础上,根据是否联用三维可视化、荧光影像技术分为观察组(n=33)和对照组(n=30)。比较两组患者的手术治疗、实验室检查指标和术后并发症情况。结果:观察组患者手术时间明显较对照组短,且术中出血量也明显少于对照组。术后病灶残留也较对照组少。两组术后3天ALT、AST和TBil差异均有统计学意义(P<0.05),观察组的ALT、AST和TBil水平显著低于对照组。结论:对于合并重度肝硬化的小肝癌行开腹或腹腔镜手术时联合三维可视化技术、吲哚菁绿荧光影像技术、超声技术有助于定位肝癌,提高治疗效果。Objective:To summarize the experience of surgery of small hepatocellular carcinoma associated with severe liver cirrhosis by using combination of three-dimensional visualization technology,indocyanine green fluorescence imaging system and ultrasonography.Methods:The data of 63 patients with small hepatocellular carcinoma who underwent laparotomy and laparoscopic surgery for severe liver cirrhosis at the General Surgery Department of our hospital from January 2019 to December 2022 were retrospectively analyzed.On the basis of intraoperative ultrasound assistance,the patients were divided into an observation group(n=33)and a control group(n=30)according to whether three-dimensional visualization and fluorescence imaging technology were combined.The surgical treatment,laboratory test indicators and postoperative complications of the two groups of patients were compared.Results:The operation time of the observation group was significantly shorter than that of the control group,and the intraoperative blood loss was also significantly less than that of the control group.The residual lesions after operation were also less than those in the control group.There were statistically significant differences in ALT,AST and TBil between the two groups 3 days after operation(P<0.05),and the levels of ALT,AST and TBil in the observation group were significantly lower than those in the control group.Conclusion:For small hepatocellular carcinoma patients with severe cirrhosis,the combination of three-dimensional visualization technology,indocyanine green fluorescence imaging technology,and ultrasound technology during open or laparoscopic surgery can help locate hepatocellular carcinoma and improve the treatment effect.

关 键 词：原发性肝癌 肝硬化 三维可视化 吲哚菁绿 荧光成像 

分 类 号：R735.1[医药卫生—肿瘤]