摘要
目的探讨混合现实(MR)术中导航联合三维可视化对复杂肝癌切除的临床运用价值。方法回顾性分析南通市肿瘤医院肝胆外科在2015年9月-2017年10月因复杂性肝癌而施行肝切除术的50例患者的临床资料,随机分为对照组和试验组,试验组22例,术前采用三维可视化技术进行术前评估,术中采用MR导航技术;对照组28例,未采用三维可视化和MR导航。试验组和对照组的手术者相同。对两组患者术前、术中和术后指标进行对比和分析。结果两组患者的术前指标差异均无统计学意义。术中指标中,试验组较对照组的手术时间[(82.3±10.4)min与(96.6±22.7)min]及肝门阻断时间[(12.2±3.8)min与(15.8±4.2)min]均明显缩短、术中出血量[(486.4±118.5)ml与(567.2±142.8)ml]及术中输血量[(1.8±0.2)U与(2.5±0.6)U]均明显减少,差异有统计学意义;术后指标中,试验组术后并发症总的发生率(4/22与13/28)比对照组低,差异有统计学意义。结论对需行复杂肝癌切除的患者,采用MR术中导航技术联合术前三维可视化技术可以明显减少手术时间、肝门阻断时间、术中出血量及输血量,明显降低术后并发症总的发生率,具有临床推广价值。
Objective To explore the application value of mixed-reality (MR) navigation combined with three-dimensional visualization technique in complicated hepatectomy. Methods A retrospective analysis of the clinical data of fifty patients with complex liver cancer who underwent liver resection in the Department of hepatobiliary surgery of Nantong Tumor Hospital during September 2015 to October 2017 was conducted. These patients were randomly divided into control group and experimental group, including 22 cases in the experimental group, using three-dimensional visualization technique for preoperative assessment, and MR surgery intraoperative navigation technology, and 28 cases in the control group, in which the three-dimensional visualization technique and the MR navigation were not performed. The surgeons of the two groups were the same. The preoperative, intraoperative and postoperative indexes of the two groups were compared and analyzed. Results There was no significant difference in preoperative indexes. But in the intraoperative indexes, the operation time [(82.3±10.4) min vs (96.6±22.7) min] and hepatic portal blocking time [(12.2±3.8) min VS (15.8±4.2) min] of the experimental group were significantly shorter than those of the control group, meanwhile, the amount of intraoperative bleeding [(486.4±118.5) ml vs (567.2±142.8) ml] and the volume of intraoperative blood transfusion of [(1.8±0.2) U vs (2.5±0.6) U] were significantly decreased. These differences were statistically significant. In the postoperatively, the total incidence of postoperative complications (4/22 vs 13/28) of the experimental group was lower than that of the control group, and the difference was statistically significant. Conclusion In complicated hepatectomy, MR intraoperative navigation combined with three-dimensional visualization technique which used for preoperative assessment can significantly shorten operation time, hepatic portal blocking time, significantly reduce intraoperative blood loss and transfusion volume, and significantly reduce the incidence of postoperative total complications, which is of clinical value.
作者
马春阳
周益龙
李怀亮
侯卫晓
邵冰峰
张素青
李国兴
刘浩峰
陈橼
张一心
Ma Chunyang;Zhou Yilong;Li Huailiang;Hou Weixiao;Shao Bingfeng;Zhang Suqing;Li Guoxing;Liu Haofeng;Chen Yuan;Zhang Yixin(Nantong Tumour Hospital of Jiangsu,Nantong 226300 China;Oncology Major,Department of Clinical Medicine,Graduate School of Medical College,Nantong University,Nantong,226019 China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2019年第4期279-283,共5页
National Medical Journal of China
基金
江苏省南通市卫计委重点病种的临床规范化诊疗项目(MS32015028)
江苏省南通市卫计委医学重点学科建设(YY201207)
南通市医学重点学科-普通外科(肝胆胰肿瘤)(学科09)
南通市医学重点学科-实验肿瘤学(学科05)
南通市青年医学重点人才(青年068).
关键词
混合现实(MR)
肝肿瘤
术中导航
三维可视化
肝切除术
Mixed reality (MR)
Liver Neoplasms
Intraoperative navigation
Three-dimensional visualization
Hepatectomy
