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目的探讨联合吲哚青绿(ICG)清除试验、单光子发射型计算机断层显像(SPECT)和三维重建技术在术前评估原发性肝癌(PLC)患者行半肝切除手术中的应用价值。方法回顾分析50例行半肝切除术的PLC患者的临床资料,其中26例观察组术前行ICG清除试验、SPECT和三维重建技术联合术前评估,另24例对照组未行联合术前评估,比较两组患者术中和术后相关指标,分析术后出现肝功能不全或其他并发症的差异。结果观察组与对照组手术时间分别为(134.2±40.7)min对(157.0±33.2)min,术后住院日分别为(12.2±4.7)d和(14.8±3.4)d,差异显著(P<0.05),而两组术中失血量、拔管天数无显著相差(P>0.05);观察组术后胆漏、腹腔积液、肺部感染、切口感染和肝功能不全发生率显著低于对照组(P<0.05)。结论联合ICG清除试验、SPECT和三维重建技术术前评估肝功能和肿瘤情况对PLC患者行半肝切除术有一定的指导意义。
Objective To investigate the value of combined indocyanine green (ICG) scintigraphy, single photon emission computed tomography (SPECT) and three-dimensional reconstruction in the preoperative evaluation of primary hepatectomy in patients with primary liver cancer (PLC). Methods The clinical data of 50 patients undergoing partial hepatectomy for PLC were retrospectively analyzed. Among them, 26 patients in the observation group underwent preoperative ICG resection, SPECT and three-dimensional reconstruction combined with preoperative evaluation, while the other 24 patients in the control group did not receive preoperative evaluation , Compared the two groups of patients during and after surgery related indicators, analysis of liver dysfunction or other complications. Results The operation time of observation group and control group were (134.2 ± 40.7) min vs (157.0 ± 33.2) min and (12.2 ± 4.7) days and (14.8 ± 3.4) days after operation, respectively ), While there was no significant difference between the two groups in the amount of blood loss and extubation days (P> 0.05). The incidences of postoperative biliary leakage, ascites, lung infection, incision infection and hepatic insufficiency in the observation group were significantly lower than those in the control group (P <0.05). Conclusions The preoperative evaluation of liver function and tumor status by combined ICG clearance test, SPECT and three-dimensional reconstruction has some guiding significance for the patients undergoing partial hepatectomy.