摘要
目的探讨血流拓扑学肝分段与Couinaud肝分段在原发性肝癌术前评估及手术规划中的应用价值。方法前瞻性纳入2018年1月至2020年6月收治的100例原发性肝癌患者,采用随机数字表法分为:Couinaud组(Couinaud肝分段进行术前评估及手术规划)和血流拓扑学组(血流拓扑学肝分段进行术前评估及手术规划),每组各50例。数据应用软件SPSS 22.0处理,围手术期相关指标等计量资料采用(x±s)表示,组间行独立样本t检验;术后并发症等计数资料行χ^(2)检验;生存分析采用Kaplan-Meier法并行Log-Rank检验。P<0.05表示差异有统计学意义。结果血流拓扑学组手术时间、术中出血量、术中输血量及术后住院时间优于Couinaud组(P<0.05);血流拓扑学组模拟切除肝体积及实际切除体积均显著低于Couinaud组(P<0.05);与模拟切除肝体积相比,Couinaud组实际切除肝体积降低更为显著(P<0.05)。两组患者术后总并发症发生率(20.0%vs.12.0%)差异无统计学意义(P>0.05)。Kaplan-Meier分析显示,两组患者累积总生存率及无病生存率比较差异无统计学意义(P>0.05)。结论与Couimud肝分段相比,血流拓扑学肝分段能更准确的预测切除肝体积,指导术中精准操作,不仅能够缩短手术时间,减少损伤,而且也有利于患者术后恢复,且预后良好。
Objective To evaluate the value of blood flow topological liver segmentation and Couinaud liver segmentation in preoperative evaluation and surgical planning of primary liver cancer.Methods A total of 100 patients with primary liver cancer admited from January 2018 to June 2020 were prospetively enolled and divided into Couinaud group(Couinaud liver segmentation for preoperative evaluation and surgical planning)and blood flow topology group(blood flow topology liver segmentation for preoperative evaluation and surgical planning)according to random number table method,with 50 patients in each group.SPSS 22.0 was used for data analysis.Perioperative related indexes were expressed by(x±s),and independent t test was performed between groups.Postoperative indicators and other measurement data were conted by χ^(2) test.Kaplan-Meier parallel Log-Rank test was used for survival analysis.P<0.05 indicated.statistical diference.Results The operative time,intraoperative blood loss,intraoperative blood transfusion and postoperative hospital stay in the blood flow topology group were better than those in the Couinaud group(P<0.05).The simulated liver volume and actual resected liver volume in the hematological topology group were signifiantly lower than those in the Couinaud group(P<0.05).Compared with the simulated resected liver volume,actual hepatectomy volume decreased more signifcantly in Couinkud group(P<0.05).There was no signifieant difference in the incidence of postoperative complicaions between the two groups(20.0%ous.12.0%),P>0.05.Kaplan-Meier analysis showed that there was no signifcant difference in cumulative overall survival and disease-free survival between 2 groups(P>0.05).Conclusion Compared with couimud liver segmentation,blood flow topology liver segmentation can more accurately predict the volume and guide accurate operation during operation.It can not only shorten the operatin time and reduce injury,but also benefit the postoperative recovery of patients with good prognosis.
作者
董奕琦
罗耀兵
刘涛
张岚
杨明
Dong Yiqi;Luo Yaobing;Liu Tao;Zhang Lan;Yang Ming(Department of Emergency,Ethnic Hospital of Enshi Tujia and Miao Autonomous Prefecturet,Enshi Hubei Province 445000,China;Department of General Surgery,Ethnic Hospital of Enshi Tujia and Miao Autonomous Prefecturet,Enshi Hubei Province 445000,China;Department of Hepatobiliary Surgery,Ethnic Hospital of Enshi Tujia and Miao Autonomous Prefecturet,Enshi Hubei Province 445000,China)
出处
《中华普外科手术学杂志（电子版）》
2022年第4期423-426,共4页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
基金
湖北省卫生计生委科研项目(WJ2019F151)。
关键词
原发性肝癌
肝切除术
肝脏分段
Primary liver cancer
Hepatectomy
Liver segmentation
