肝脏影像解读分析系统在精准肝切除手术规划中的应用
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摘要
目的探讨肝脏影像解读分析系统下的精准肝切除手术规划对原发性肝细胞癌的临床价值。方法选取原发性肝癌患者80例,选择前瞻性研究方式,将选择术前肝脏影像解读分析系统指导精准肝切除术的40例为观察组,选择二维影像指导的普通肝切除术的40例为对照组,对比两组患者的手术指标、肝功能以及并发症情况。结果观察组患者手术时间较对照组明显延长(P<0.05),肝门阻断时间、住院时间较对照组均明显缩短(P<0.05);手术输血量、术中出血量较对照组均明显减少(P<0.05)。观察组术后第3天的TBIL、MELD评分均明显低于对照组(P<0.05)。观察组患者术后并发症发生率明显低于对照组(P<0.05)。结论肝脏影像解读分析系统下的精准肝切除手术规划相比常规手术时间较长,但是可以有效缩短术后恢复时间,减少手术创伤,提高残余肝功能水平,减少术后并发症,具有较高的临床价值。
Objective To explore the clinical value of accurate liver resection planning under the liver imaging interpretation analysis system for primary hepatocellular carcinoma.Methods Total of 80 patients with primary liver cancer was selected which were prospective study way.The interpretation was chosen preoperative liver imaging analysis system for guiding precision of 40 cases of liver resection as the observation group,was chosen the 2Dimage guidance common liver resection of 40 cases of control group,and compared two groups of patients with surgical index,liver function and complications.Results The operative time of patients in the observation group was significantly longer than the control group(P<0.05),the duration of hepatic portal block and the length of hospital stay,all of which were significantly shorter than those in the control group(P<0.05).Operative blood transfusion volume and intraoperative blood loss were significantly reduced compared with the control group(P<0.05).After surgery 3days,the TBIL of the observation group and the MELD score,both significantly lower than the control group(P<0.05).The incidence of postoperative complications in the observation group significantly lower than that in the control group(P<0.05).Conclusion The precision liver resection plan under the liver image interpretation system is longer than the conventional operation time,but it can effectively shorten the postoperative recovery time,reduce the surgical trauma,improve the residual liver function level,reduce postoperative complications,and have a high clinical value.
Objective To explore the clinical value of accurate liver resection planning under the liver imaging interpretation analysis system for primary hepatocellular carcinoma.Methods Total of 80 patients with primary liver cancer was selected which were prospective study way.The interpretation was chosen preoperative liver imaging analysis system for guiding precision of 40 cases of liver resection as the observation group,was chosen the 2Dimage guidance common liver resection of 40 cases of control group,and compared two groups of patients with surgical index,liver function and complications.Results The operative time of patients in the observation group was significantly longer than the control group(P<0.05),the duration of hepatic portal block and the length of hospital stay,all of which were significantly shorter than those in the control group(P<0.05).Operative blood transfusion volume and intraoperative blood loss were significantly reduced compared with the control group(P<0.05).After surgery 3days,the TBIL of the observation group and the MELD score,both significantly lower than the control group(P<0.05).The incidence of postoperative complications in the observation group significantly lower than that in the control group(P<0.05).Conclusion The precision liver resection plan under the liver image interpretation system is longer than the conventional operation time,but it can effectively shorten the postoperative recovery time,reduce the surgical trauma,improve the residual liver function level,reduce postoperative complications,and have a high clinical value.
引文
[1]侯建存,张雅敏,王连江,等.肝脏影像解读分析系统在精准肝切除手术规划中的应用[J].中国普外基础与临床杂志,2014,21(2):142-145.
[2]贺爱.3D+医学影像可视化处理系统行肝体积测量的准确性的初步研究[D].山西医科大学,2017.
[3]杨志龙.虚拟技术在精准肝切除治疗原发性肝细胞肝癌的价值[D].南昌大学医学院,南昌大学,2014.
[4] Singal AK,Kamath PS.Model for end-stage liver disease[J].Journal of Clinical&Experimental Hepatology,2013,3(1):50-60.
[5]张晓媛,黄鹏,李燕京,等.晚期原发性肝癌治疗的研究进展[J].现代肿瘤医学,2017,25(10):1655-1659.
[6]丛文铭,步宏,陈杰,等.原发性肝癌规范化病理诊断指南(2015版)[J].临床与实验病理学杂志,2015,31(3):241-246.
[7]王均干,侯海燕,姜建威,等.256层MSCT肝脏体积测量在肝肿瘤行精准肝切除中的初步应用[J].中国现代手术学杂志,2015,21(6):471-474.
[8]熊永福,闫再华,杨召,等.肝脏影像分析解读系统在肝脏手术规划中的应用[J].临床肝胆病杂志,2015,31(8):1317-1320.
[9]王金伟,张雅敏.肝切除术中确定肿瘤边界方法的研究进展[J].临床肝胆病杂志,2016,32(2):374-377.
[10]陈琳,罗鸿萍,董水林,等.三维重建技术在评估大肝癌手术安全性中的作用[J].中华外科杂志,2016,54(9):669-674.
[2]贺爱.3D+医学影像可视化处理系统行肝体积测量的准确性的初步研究[D].山西医科大学,2017.
[3]杨志龙.虚拟技术在精准肝切除治疗原发性肝细胞肝癌的价值[D].南昌大学医学院,南昌大学,2014.
[4] Singal AK,Kamath PS.Model for end-stage liver disease[J].Journal of Clinical&Experimental Hepatology,2013,3(1):50-60.
[5]张晓媛,黄鹏,李燕京,等.晚期原发性肝癌治疗的研究进展[J].现代肿瘤医学,2017,25(10):1655-1659.
[6]丛文铭,步宏,陈杰,等.原发性肝癌规范化病理诊断指南(2015版)[J].临床与实验病理学杂志,2015,31(3):241-246.
[7]王均干,侯海燕,姜建威,等.256层MSCT肝脏体积测量在肝肿瘤行精准肝切除中的初步应用[J].中国现代手术学杂志,2015,21(6):471-474.
[8]熊永福,闫再华,杨召,等.肝脏影像分析解读系统在肝脏手术规划中的应用[J].临床肝胆病杂志,2015,31(8):1317-1320.
[9]王金伟,张雅敏.肝切除术中确定肿瘤边界方法的研究进展[J].临床肝胆病杂志,2016,32(2):374-377.
[10]陈琳,罗鸿萍,董水林,等.三维重建技术在评估大肝癌手术安全性中的作用[J].中华外科杂志,2016,54(9):669-674.