摘要
目的:探讨术中超声在肝脏肿瘤手术中的作用.方法:对78例肝脏肿瘤患者行术中超声扫描,与术前超声和CT/增强CT进行对比分析.结果:本组肝脏恶性肿瘤共65例,术前超声和术前CT/增强CT分别有10例和6例不符合,而术中超声全部诊断准确.术中超声对于肝血管瘤的诊断准确率(92.31%)也要高于术前超声(69.23%)和CT/增强CT(76.92%).术中超声对直径≤1cm的小肿瘤检出率达90.48%.明显优于术前超声(59.52%)和CT/增强CT(69.05%)(P<0.05).术中超声对直径>1 cm者检出率为100%.术中超声总体病灶检出率为96.36%,也明显优于术前超声(74.55%) (P<0.05).对22例患者改变了原定的手术方案.所有切除病灶均由术中超声预先确定切除线和切除径路,使切缘无癌细胞残留.结论:与术前超声和CT/增强CT相比,术中超声对肝脏肿瘤定性定位诊断准确,提高了手术的安全性和彻底性,是微创观念在肝脏肿瘤手术中的体现.
AIM： To investigate the application of intraoperative ultrasound to surgery for liver neoplasms.
METHODS： Intraoperative ultrasound was used to scan 78 patients with liver neoplasms. The results of intraoperative ultrasound were compared with those of preoperative ultrasound and computed tomography （CO/enhanced CT.
RESULTS： Of 65 patients suffering from liver cancer, intraoperative ultrasound determined all cases, whereas preoperative ultrasound and CT/enhanced CT missed 10 and 6 cases, respectively. For diagnostic accuracy of liver hemangioma, intraoperative ultrasound was better than preoperative ultrasound and CT/enhanced CT （92.31% vs 69.23% and 76.92%, respectively）. For small-sized foci with diameters≤ 1.0 cm, intraoperative ultrasound had a statistically significant better detection rate than preoperative ultrasound or CT/enhanced CT （90.48% vs 59.52% and 69.05%, respectively, both P 〈 0.05）. Intraoperative ultrasound could also better ascertain lesions with diameters bigger. The detection rate was 96.36%, which was significantly higher than that of preoperative ultrasound （74.55%, P 〈 0.05）. The operative style was changed in 22 patients and all lesions were removed after intraoperative ultrasound scans that then determined the resection line and pathway. No residual cancer cells were found at the cutting edge.
CONCLUSION： Compared with preoperative ultrasound and CT/enhanced CT, intraoperative ultrasound is accurate in its diagnosis of quality and localization of liver neoplasms. Thus intraoperative ultrasound, a minimally invasive concept, enhances the security of surgery and the degree of thoroughness for patients with liver tumors.
出处
《世界华人消化杂志》
CAS
北大核心
2007年第23期2549-2552,共4页
World Chinese Journal of Digestology
关键词
术中超声
肝脏肿瘤
微创观念
Intraoperative ultrasound
Liver neoplasms
Minimally invasive procedure
