摘要
目的探讨三维虚拟技术应用多处肝切除术治疗复杂肝胆管结石病中的临床价值。方法选取2015年8月~2018年6月行多处肝切除术治疗的90例复杂肝胆结石病患者为对象,按电脑数字表法随机分为两组,每组各45例,对照组予以CT检查,实验组予以三维虚拟技术检查,对比分析两组术前诊断情况与手术情况。结果实验组术前病理分型与术中所见符合率是97.78%,较对照组的71.11%高,差异有统计学意义(P<0.05);实验组门静脉分型与术中所见符合率是95.56%,肝静脉分型与术中所见符合率是93.33%,分别较对照组的80.00%、77.78%高,差异有统计学意义(P<0.05);实验组手术用时、术中出血量、输血量均较对照组少,差异有统计学意义(P<0.05);实验组并发症发生率是4.44%,较对照组的20.00%低,差异有统计学意义(P<0.05);实验组残石、肝内胆管狭窄残留、结石复发率均较对照组低,差异有统计学意义(P<0.05)。结论三维虚拟技术应用于多处肝切除术治疗复杂肝胆管结石病中可明确术前病理分型及门静脉、肝静脉情况,以便于制定个体化手术方案,避免术中盲目探查,提升手术效果及安全性。
Objective To explore the clinical value of three-dimensional virtual technology in the treatment of complex hepatolithiasis by multiple hepatectomy.Methods 90 patients with complicated hepatolithiasis who admitted to our hospital from August 2015 to June 2018 and underwent multiple hepatectomy were enrolled in the research,all of these patients were randomly divided into two groups according to computer-generated number table method,with 45 cases in each group.The control group was examined by ordinary CT and the experimental group was examined by three-dimensional virtual technique.The preoperative diagnosis andpostoperative conditions were compared between the two groups.Results The preo-perative pathological type of the experimental group was 97.78%consistent with the intraoperative findings,which was higher than that of the control group 71.11%,with statistically significant(P<0.05).The coincidence rate of portal vein classification and intraoperative findings in the experimental group was 95.56%,and the coincidence rate of hepatic vein classification and intraoperative was 93.33%,which were higher than those of the control group 80.00%and 77.78%,respectively,with statistically significant(P<0.05).The experimental group was less than the control group in terms of surgery time,intraoperative blood loss and blood transfusion volume,with statistically significant(P<0.05).The incidence of complications in the experimental group was 4.44%,which was lower than that of the control group 20.00%,with statistically significant(P<0.05).The residual rate of residual stones,the residual rate of intrahepatic bile duct stenosis,and the recurrence rate of stones in the experimental group were lower than those in the control group,with statistically significant(P<0.05).Conclusion The application of three-dimensional virtual technology in clinical multi-site hepatectomy for complex hepatolithiasis can clearly clarify the preoperative pathological classification,portal vein and hepatic vein,so as to facilitate the formulation o
作者
姚意
唐才喜
易波
汪新天
YAO Yi;TANG Caixi;YI Bo;WANG Xintian(Hepatobiliary Pancredic Splenic Srugery, Zhuzhou Central Hospital, Zhuzhou 412001, P.R.China;Hepatobiliary Pancredic Splenic Srugery, Hunan Provincial People's Hospital, Changsha 410002, P.R.China)
出处
《医学影像学杂志》
2020年第12期2248-2253,共6页
Journal of Medical Imaging
基金
湖南省科技计划项目(编号:2016SK4006)。
关键词
三维虚拟技术
多处肝切除术
复杂肝胆管结石
术前诊断
肝胆管结构
Three-dimensional virtual technology
Multiple hepatectomy
Complex hepatolithiasis
Preoperative diagnosis
Hepatobiliary duct structure
