3D重建技术指导下的精准肝切除术治疗儿童肝脏间叶性错构瘤的效果与安全性分析  

Effect and Safety Analysis of 3D Reconstruction Technique-guided Precise Hepatectomy on Mesenchymal Hamartoma of Liver in Children

作　　者：黄白沙[1] 黄艺文 董踌 HUANG Baisha;HUANG Yiwen;DONG Chou(Guangdong Maternal and Child Health Hospital,Guangdong Guangzhou 511442,China)

机构地区：[1]广东省妇幼保健院小儿普外科,广东广州511442

出　　处：《河北医学》2025年第2期274-281,共8页Hebei Medicine

基　　金：广东省医学科学技术研究基金项目,(编号:A202301286)。

摘　　要：目的:探讨3D重建技术指导下的精准肝切除术在肝脏间叶性错构瘤(MHL)儿童治疗中的应用价值。方法:选取2019年1月至2023年5月我院102例MHL儿童,随机数字表法分为两组,每组51例。常规组给予常规精准肝切除术,3D组给予3D重建技术指导下的精准肝切除术。比较两组手术指标、手术前后炎性应激指标[白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]、肝胆功能指标[丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、结合胆红素(DBIL)、间接胆红素(IBIL)]、术后疼痛程度(VAS)评分、生存质量[生存质量评分]及并发症发生率,并随访1年,统计两组复发率。结果:3D组术中出血量少于常规组,手术时间、肝动脉阻断时间、住院时间短于常规组,差异均有统计学意义(P<0.05);术后1d、3d、7d 3D组CRP、IL-6、TNF-α、AST、ALT、TBIL、DBIL、IBIL低于常规组,差异均有统计学意义(P<0.05);3D组术后12h、24h、48h、72h VAS评分低于常规组,差异均有统计学意义(P<0.05);术后3个月3D组生存质量各维度评分均高于常规组,差异均有统计学意义(P<0.05);3D组并发症发生率(3.92%)低于常规组(17.65%),差异均有统计学意义(P<0.05);随访1年两组复发率比较差异无统计学意义(P>0.05)。结论:3D重建技术指导下的精准肝切除术治疗儿童MHL,可优化手术,降低炎性反应和疼痛程度,促进术后恢复,改善肝功能,减少并发症发生,提高生活质量,远期疗效确切。Objective:To evaluate the clinical value of 3D reconstruction technique-precision hepatectomy in the treatment of mesenchymal hamartoma of liver(MHL)in children.Methods:A total of 102 children with MHL in our hospital from January 2019 to May 2023 were randomized 1:1 to conventional precise hepatectomy(conventional group)or 3D reconstruction technique-precision hepatectomy(3D group).The surgical indexes,inflammatory stress indexes(Interleukin-6[IL-6]),Tumor necrosis factor-α[TNF-α],(C-reactive protein[CRP]),liver function indexes(alanine aminotransferase[ALT],aspartate aminotransferase[AST],total bilirubin[BIL],direct bilirubin[DBIL],indirect bilirubin[IBIL]),Visual Analogue scale(VAS)for postoperative pain,quality-of-life(QOL)scores,and complication rate,were included as comparisons before and after surgery between groups.The recurrence rate of the two groups following 1-year follow-up was assessed.Results:The amount of blood loss in the 3D group was statistically less than that in the conventional group,the time to operation,time to hepatic artery occlusion and hospital stay were significantly shorter than those in the conventional group(P<0.05).The levels of CRP,IL-6,TNF-α,AST,ALT,TBIL,DBIL,and IBIL in 3D groups at 1,3 and 7 days of surgery were significantly lower than those in conventional group(P<0.05).The VAS scores at 12 h,24 h,48 h and 72 h in the 3D group were significantly lower than those in the conventional group(P<0.05).After 3 months of surgery,the QLL scores in 3D group were significantly higher than those in conventional group(P<0.05).The complication rate of 3D group was significantly lower than that of conventional group(3.92%vs 17.65%,P<0.05).There was no significant difference in the recurrence rate between the two groups at 1 year of follow-up(P>0.05).Conclusion:The 3D reconstruction technology-guided precise hepatectomy in the treatment of pediatric MHL can optimize the surgery,reduce inflammatory response and pain degree,promote postoperative recovery,improve liver function,reduce compl

关 键 词：错构瘤 肝脏 肝切除术 3D重建技术 

分 类 号：R735.7[医药卫生—肿瘤]