摘要
目的:分析多层螺旋CT血管造影(MSCTA)肠系膜血管评估在腹腔镜结直肠癌手术中的应用价值。方法:回顾选择在医院进行手术治疗的76例结直肠癌患者,将术前行全腹MSCTA及三维重建的患者作为观察组(40例);术前行常规CT检查的患者作为对照组(36例),对比两组术中、术后各项临床指标的差异性。结果:观察组患者MSCTA重建肠系膜血管及其分支走向情况与术前MSCTA检查结果符合率为100.00%,该组患者血管变异发生率为10.00%。两组患者淋巴结清扫数量、肛门排气时间以及住院时间对比无显著差异;观察组术中出血量、手术时间及腹腔引流量显著优于对照组,差异有统计学意义(t=8.920,t=7.562,t=8.322;P<0.05);观察组并发症总发生率显著低于对照组,差异有统计学意义(x2=6.116,P<0.05)。结论:MSCTA肠系膜血管评估在腹腔镜结直肠手术治疗前的应用可有效判断动脉血管起始变异与吻合支情况,从而在保证手术治疗安全性前提下提高手术治疗效果,对患者治疗结局及预后的改善均具有积极意义。
Objective:To analyze the application value of mesenteric vascular assessment with multi-slice spiral CT angiography(MSCTA)in colorectal cancer surgery with laparoscope.Methods:76 patients with colorectal cancer who underwent surgery in hospital were retrospectively enrolled in the study.40 patients who underwent preoperative MSCTA of entire abdomen and three-dimensional(3D)reconstruction were divided into observation groups,and 36 patients who underwent preoperative routine CT examination were divided into control group.And the differences of each intraoperative and postoperative clinical indexes between the two groups were compared.Results:The coincidence rate between the situation of mesenteric vessels of MSCTA reconstruction and their branching trend of observation group and examination results of preoperative MSCTA was 100.0%.And the incidence of blood vessel variation of observation group was 10.00%.The differences of the number of lymph node dissection,anal evacuation time and hospitalization time between two groups were not significant.The amount of bleeding,operation time and abdominal drainage volume of observation group were significantly better than those of control group(t=8.920,t=7.562,t=8.322,P<0.05).The total incidence of complications of observation group was significantly lower than that of control group(x2=6.116,P<0.05).Conclusion:The application of mesenteric vessel assessment with MSCTA pre colorectal surgery with laparoscope can effectively judge the situations of origin variation of arterial blood vessel and anastomotic branches,thus can improve the therapeutic effect of surgery under the premise of ensuring the safety of surgical treatment.Therefore,it has a positive significance for the treatment outcome and prognostic improvement of patients.
作者
蒋光耀
杜训松
孟春
强光刘
张培培
JIANG Guang-yao;DU Xun-song;MENG Chun(Department of Radiology,Anhui NO.2 Provincial People's Hospital,Hefei 230041,China)
出处
《中国医学装备》
2019年第12期61-64,共4页
China Medical Equipment
关键词
多层螺旋CT
血管造影
肠系膜血管评估
腹腔镜
结直肠癌
Multi-slice spiral CT
Angiography
Mesenteric vascular assessment
Laparoscope
Colorectal cancer
