CAJ | 학술논문

目的探讨数字化三维重建系统在肝泡型包虫病(HAE)治疗中的应用价值.方法采用数字化三维重建系统对2011年2月至10月新疆医科大学第一附属医院收治的13例HAE患者的肝脏CT检查数据进行三维重建及智能分析,术前评估可切除性,设计合理的手术方案,完成术前个体化虚拟手术,并与术中实际情况作比较.结果 13例患者CT检查数据三维重建结果满意,肝内病灶及相关管道关系显示清晰.l例患者行体外肝切除+自体肝移植术,10例行肝切除术,2例行PTCD,与虚拟手术设计方案一致.术前通过三维重建系统对11例拟行手术的患者进行虚拟手术设计,测得预切除肝脏平均体积为920 ml(339～2678ml)；切除肝脏体积占全肝体积平均为45％(23％～68％).患者实际切除肝脏平均体积为834 ml(315 ～2250 ml)；术中切除肝脏体积占全肝体积平均为42％ (22％～70％),与术前三维重建结果基本一致.术后随访2～8个月,所有患者未出现肝功能衰竭、出血、胆汁漏等严重并发症.结论数字化三维重建系统有助于确定HAE合理的手术方式,有效降低了手术风险.
목적 탐토수자화삼유중건계통재간포형포충병(HAE)치료중적응용개치.방법 채용수자화삼유중건계통대2011년2월지10월신강의과대학제일부속의원수치적13례HAE환자적간장CT검사수거진행삼유중건급지능분석,술전평고가절제성,설계합리적수술방안,완성술전개체화허의수술,병여술중실제정황작비교.결과 13례환자CT검사수거삼유중건결과만의,간내병조급상관관도관계현시청석.l례환자행체외간절제+자체간이식술,10례행간절제술,2례행PTCD,여허의수술설계방안일치.술전통과삼유중건계통대11례의행수술적환자진행허의수술설계,측득예절제간장평균체적위920 ml(339～2678ml)；절제간장체적점전간체적평균위45％(23％～68％).환자실제절제간장평균체적위834 ml(315 ～2250 ml)；술중절제간장체적점전간체적평균위42％ (22％～70％),여술전삼유중건결과기본일치.술후수방2～8개월,소유환자미출현간공능쇠갈、출혈、담즙루등엄중병발증.결론 수자화삼유중건계통유조우학정HAE합리적수술방식,유효강저료수술풍험.
Objective To investigate the value of a digital three-dimensional reconstruction technique in the treatment of hepatic alveolar echinococcosis (HAE).Methods The computed tomography scan data for 13 patients with HAE who were admitted to the First Affiliated Hospital of Xinjiang Medical University from February 2011 to October 2011 were reconstructed and analyzed by a three-dimensional reconstruction system to assess resectability,and to facilitate surgical planning and individualized virtual surgery.The results of preoperative analysis were compared with the results of actual operations.Results The three-dimensional models of the liver were reconstructed successfully,and intrahepatie lesions and vessels were clearly displayed.One patient received an autologous liver transplantation,10 underwent hepatectomy,and 2 received percutaneous transhepatic cholangial drainage.Virtual operation planning was carried out for 11 patients using the three-dimensional reconstruction system.The mean volume of the liver to be resected was predicted to be 920 ml (range,339-2678 ml),and the mean percentage of liver to be resected to the total liver volume was predicted to be 45％ ( range,23％ -68％ ).The mean volume o[ the actual liver resection was 834 ml (range,315-2250 m[),and the mean percentage of actual liver resected to the total liver volume was 42％ (range,22％ -70％ ),which was consistent with the results of preoperative three-dimensional reconstruction.All patients were followed up for 2-8 months,and no severe complications such as liver failure,hemorrhage and bile leakage were detected.Conclusion Digital three-dimen-sional reconstruction is helpful in the diagnosis and treatment of HAE and effectively reduces surgical risks.