中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2009年
5期
409-412
,共4页
李晓航%张佳林%王凤山%王学梅%易德会%富大智%李鹏%刘永锋
李曉航%張佳林%王鳳山%王學梅%易德會%富大智%李鵬%劉永鋒
리효항%장가림%왕봉산%왕학매%역덕회%부대지%리붕%류영봉
肝肿瘤%超声检查,多普勒,彩色%外科手术
肝腫瘤%超聲檢查,多普勒,綵色%外科手術
간종류%초성검사,다보륵,채색%외과수술
Liver neoplasms%Uhrasonography,Doppler,color%Surgical procedures,operative
目的 探讨术中超声在肝脏肿瘤手术中的应用价值.方法 对45例肝脏肿瘤患者行术中超声检查(Logiq 500型超声仪,5～7.5 MHz线阵式术中专用探头),并与术前超声(PHILIPSHDI 5000型超声仪,3.5～5 MHz凸阵式探头)和增强CT检查对比分析,比较三者在病灶检出率方面的差异.结果 术中超声对直径≥1 cm病灶的检出率为100%,高于术前超声(89.80%)和CT(97.96%)的检出率,但差异无统计学意义(术前超声xc2=3.372,P>0.05,CT Fisher确切概率为P=1.00);术中超声对直径<1 cm病灶的检出率为90.70%,明显高于术前超声的检出率(62.79%)和CT检出率(74.42%)(术前超声x2=9.382,CT x2=3.957,均P<0.05);术中超声对病灶的总体检出率为95.65%,明显高于术前超声的检出率(77.17%)和CT检出率(86.96%)(术前超声x2=13.378,CT x2=4.381,均P<0.05),所有新发现的病灶都在术中超声的引导下行手术切除或无水乙醇瘤内注射.结论 与术前影像学检查相比,术中超声可以提高隐匿部位和微小病灶的检出率,有助于指导外科操作和手术治疗.
目的 探討術中超聲在肝髒腫瘤手術中的應用價值.方法 對45例肝髒腫瘤患者行術中超聲檢查(Logiq 500型超聲儀,5～7.5 MHz線陣式術中專用探頭),併與術前超聲(PHILIPSHDI 5000型超聲儀,3.5～5 MHz凸陣式探頭)和增彊CT檢查對比分析,比較三者在病竈檢齣率方麵的差異.結果 術中超聲對直徑≥1 cm病竈的檢齣率為100%,高于術前超聲(89.80%)和CT(97.96%)的檢齣率,但差異無統計學意義(術前超聲xc2=3.372,P>0.05,CT Fisher確切概率為P=1.00);術中超聲對直徑<1 cm病竈的檢齣率為90.70%,明顯高于術前超聲的檢齣率(62.79%)和CT檢齣率(74.42%)(術前超聲x2=9.382,CT x2=3.957,均P<0.05);術中超聲對病竈的總體檢齣率為95.65%,明顯高于術前超聲的檢齣率(77.17%)和CT檢齣率(86.96%)(術前超聲x2=13.378,CT x2=4.381,均P<0.05),所有新髮現的病竈都在術中超聲的引導下行手術切除或無水乙醇瘤內註射.結論 與術前影像學檢查相比,術中超聲可以提高隱匿部位和微小病竈的檢齣率,有助于指導外科操作和手術治療.
목적 탐토술중초성재간장종류수술중적응용개치.방법 대45례간장종류환자행술중초성검사(Logiq 500형초성의,5～7.5 MHz선진식술중전용탐두),병여술전초성(PHILIPSHDI 5000형초성의,3.5～5 MHz철진식탐두)화증강CT검사대비분석,비교삼자재병조검출솔방면적차이.결과 술중초성대직경≥1 cm병조적검출솔위100%,고우술전초성(89.80%)화CT(97.96%)적검출솔,단차이무통계학의의(술전초성xc2=3.372,P>0.05,CT Fisher학절개솔위P=1.00);술중초성대직경<1 cm병조적검출솔위90.70%,명현고우술전초성적검출솔(62.79%)화CT검출솔(74.42%)(술전초성x2=9.382,CT x2=3.957,균P<0.05);술중초성대병조적총체검출솔위95.65%,명현고우술전초성적검출솔(77.17%)화CT검출솔(86.96%)(술전초성x2=13.378,CT x2=4.381,균P<0.05),소유신발현적병조도재술중초성적인도하행수술절제혹무수을순류내주사.결론 여술전영상학검사상비,술중초성가이제고은닉부위화미소병조적검출솔,유조우지도외과조작화수술치료.
Objective To evaluate intraoporative ultrasonography (IOUS) of liver tumors. Methods In this study, 45 patients with liver tumors were examined by the IOUS(Logiq 500 scanner with a dedicated 5 ～ 7.5 MHz linear-array intraoperative transducer), and the results of IOUS were compared with those of preoperative ultrasonography (PHILIPS HDI 5000 scanner with a 3.5 ～ 5 MHz convex-array transducer) and computed tomography (CT). Results For tumors with a diameter ≥ 1 cm, the detection rate of IOUS was 100%, which was higher than that of preoperative ultrasonography and CT (100% vs 89.80% and 97.96%), though there was no statistical significance(xc2 = 3.372 ,P >0.05 and Fisher exact probability was 1.00) ; For tumors with a diameter < 1 cm, IOUS had a significantly higher detection rate than preoperative uhrasonography and CT(90.70% vs 62.79% and 74.42%, respectively,the former x2= 9.382, the latter x2 = 3.957, both P < 0.05) ;The total detection rate of IOUS was significantly higher than that of preoperative ultrasonography and CT (95.65% vs 77.17% and 86. 96%, respectively, the former x2 = 13.378, the latter x2 = 4.381, both P < 0.05). All the detected lesions underwent surgical resection or intratumoral injection of ethanol with the guidance of IOUS. Conclusions Compared with preoperative imaging examination, IOUS not only can enhance the detection rates of preoperatively overlooked lesions, but also can provide more valuable information to guide the surgical procedures.
