计算机辅助手术系统在评估儿童肝血管瘤转归中的应用  

Role of computer assisted surgery system in evaluating clinical outcomes of hepatic hemangioma in children

作　　者：修文丽 赵彩红 刘洁 王雪峰[1,2] 王菲菲 张警丽 朱荣坤 郝希伟 董蒨[1,2] Xiu Wenli;Zhao Caihong;Liu Jie;Wang Xuefeng;Wang Feifei;Zhang Jingli;Zhu Rongkun;Hao Xiwei;Dong Qian(Department of Pediatric Surgery,Affiliated Hospital of Qingdao University,Qingdao 266003,China;Shandong Provincial Key Laboratory of Digital Medicine and Computer-Assisted Surgery,Qingdao 266003,China;Department of Pediatric Healthcare,Qingdao Maternal&Children’s Health&Family Planning Service Center,Qingdao 266000,China;Department of Pediatric Surgery,Affiliated Yijishan Hospital,Wannan Medical College,Wuhu 241000,China)

机构地区：[1]青岛大学附属医院小儿外科,青岛266003 [2]山东省数字医学与计算机辅助手术重点实验室,青岛266003 [3]青岛市妇幼保健计划生育服务中心儿童保健科,青岛266000 [4]皖南医院第一附属医院(弋矶山医院)小儿外科,芜湖241000

出　　处：《临床小儿外科杂志》2025年第1期53-57,共5页Journal of Clinical Pediatric Surgery

基　　金：国家自然科学基金(82293665);青岛市关键技术攻关及产业化示范类项目(24-1-4-xxgg-16-nsh)。

摘　　要：目的探讨计算机辅助手术系统(Hisense CAS)在评估普萘洛尔治疗儿童肝血管瘤疗效中的临床价值。方法回顾性分析2010年1月至2020年12月于青岛大学附属医院小儿外科行口服普萘洛尔治疗的21例肝血管瘤患儿临床资料,应用Hisense CAS将患儿的CT资料进行三维重建,分析瘤体与血管关系、肝脏和瘤体体积等三维特征。结果本研究中男12例、女9例;局灶型16例,多发型4例,弥漫型1例;肝右叶9例,肝左叶9例,累及双叶3例。普萘洛尔治疗前后肿瘤明显减小,三维重建结果显示治疗前肿瘤体积56.8(26.0,168.4)cm^(3),治疗后减少至10.9(8.3,22.2)cm^(3);治疗前肿瘤占肝脏总体积百分比为23.1%(10.7%,53.6%),治疗后降低为3.7%(2.7%,8.1%);差异均具有统计学意义(P<0.05)。普萘洛尔治疗后,肿瘤体积缩小百分比为70.0%(47.6%,89.0%),正常肝脏体积增大百分比8.3%(2.5%,14.4%)。结论Hisense CAS三维重建在儿童肝血管瘤体积评估方面具有优势,而重建后的肝脏体积、肿瘤占肝脏体积的百分比等整体指标也为肿瘤转归的评估提供了新角度。Objective To explore the clinical value of Hisense CAS in evaluating the efficacy of propranolol for hepatic hemangioma in children.Methods A retrospective analysis was conducted for the relevant clinical data of 21 children treated with oral propranolol Affiliated Hospital of Qingdao University from January 2010 to December 2020.Hisense CAS was utilized for reconstructing the data of computed tomography(CT)and examining the three-dimensional relationship between tumor and blood vessels,liver and tumor volume.Results There were 12 males and 9 females.Focal type in 16 cases,multitype in 4 cases,diffuse type in 1 case;There were 9 cases of right lobe of liver,9 cases of left lobe of liver,and 3 cases of bilateral lobe involved.Tumor size significantly shrank after a treatment of propranolol.Three-dimensional reconstruction results indicated that tumor volume was 56.8(26.0168.4)cm^(3) pre-treatment and it declined to 10.9(8.3,22.2)cm^(3) post-treatment.The percentage of tumor to total liver volume pre-treatment was 23.1%(10.7%,53.6%).It dropped to 3.7%(2.7%,8.1%)post-treatment and the differences were statistically significant(P<0.05).After a treatment of propranolol,percentage of tumor volume reduction was 70.0%(47.6%,89.0%)and percentage of liver volume expansion was 8.3%(2.5%,14.4%).Conclusions Hisense CAS three-dimensional reconstruction offers advantages in evaluating volume of hepatic hemangiomas in children.Reconstructed liver volume and percentage of tumor to liver volume provide a new perspective for evaluating tumor outcomes.

关 键 词：肝血管瘤 普萘洛尔 外科手术 儿童 

分 类 号：R73[医药卫生—肿瘤]