選擇性門(mén)靜脈栓塞在晚期肝泡型包蟲(chóng)病治療中的應(yīng)用
發(fā)布時(shí)間:2021-04-12 14:07
目的:探討選擇性門(mén)靜脈栓塞(PVE)在晚期肝泡型包蟲(chóng)病治療中的療效及應(yīng)用價(jià)值。方法:對(duì)于新疆醫(yī)科大學(xué)第一附屬醫(yī)院肝膽包蟲(chóng)科2014年9月至2018年4月期間行選擇性門(mén)靜脈栓塞術(shù)治療的6例中晚期肝泡型包蟲(chóng)病患者的臨床資料進(jìn)行回顧性分析,患者中男性3例,女性3例,年齡區(qū)間為2168歲,平均年齡為40.67±19.31歲;術(shù)前腹部CTA明確診斷肝泡型包蟲(chóng)病,其中1例有肺部轉(zhuǎn)移,1例合并慢性肝炎,術(shù)前患者Child-Pugh分級(jí)均為A級(jí);三維肝臟重建影像技術(shù),測(cè)量全部患者肝臟體積,病灶體積,殘留肝臟體積,預(yù)計(jì)術(shù)后殘余肝臟體積不足,不宜一期行根治性手術(shù)的肝泡型包蟲(chóng)病患者,在數(shù)字化造影引導(dǎo)下實(shí)施選擇性門(mén)靜脈栓塞術(shù),待剩余肝體積代償增生后行二期手術(shù)。分析患者人口統(tǒng)計(jì)學(xué),一般臨床病例資料,記錄PVE前后剩余肝體積變化情況,PVE前后肝功能變化情況;PVE及二期手術(shù)方式,并發(fā)癥;進(jìn)行嚴(yán)密隨訪,記錄二期術(shù)后剩余肝體積的變化情況,分析PVE的遠(yuǎn)期效應(yīng)。計(jì)量資料的比較采用t檢驗(yàn),成組計(jì)量資料的比較采用兩獨(dú)立樣本資料的t檢驗(yàn)。結(jié)果:6例患者均成功實(shí)施PVE,1例患者出現(xiàn)腹痛,1例患者出現(xiàn)惡...
【文章來(lái)源】:新疆醫(yī)科大學(xué)新疆維吾爾自治區(qū)
【文章頁(yè)數(shù)】:46 頁(yè)
【學(xué)位級(jí)別】:碩士
【部分圖文】:
門(mén)靜脈栓塞:[1A:門(mén)靜脈數(shù)字化造影;1B:門(mén)靜脈右支主干栓塞;1C:PVE術(shù)前PET-CT及病灶邊緣的測(cè)定;1D:PVE術(shù)前CT;1E:根治性術(shù)前CT]
圖 2 3D 數(shù)字化重建模型:[2A:病灶與肝實(shí)質(zhì)關(guān)系(淺黃色為病灶,藍(lán)色為肝組織);2B:全肝虛擬重建;2C:病灶與脈管的關(guān)系;1D:3D 虛擬手術(shù)后重建]Fig.2 3D reconstruction model:[2A: relationship between lesions and liver parenchyma (lightyellow for lesions, blue for liver tissue); 2B: liver virtual reconstruction; 2C: The relationshipbetween the lesion and the vessel; 2D: Reconstruction after virtual surgery ]
圖 3 患者隨訪期間剩余肝(FLR)體積容量變化Fig.3 Changes in FLR volume capacity during follow-up
【參考文獻(xiàn)】:
期刊論文
[1]肝泡型包蟲(chóng)病術(shù)后肝衰竭相關(guān)危險(xiǎn)因素分析及防治[J]. 許曉磊,王志鑫,任利,侯立朝,陽(yáng)丹才讓,周灜,王海久,鄧勇,樊海寧. 中華肝臟外科手術(shù)學(xué)電子雜志. 2018(06)
[2]肝泡型包蟲(chóng)病外科根治性治療的新理念與策略[J]. 王文濤,楊闖,嚴(yán)律南. 中華醫(yī)學(xué)雜志. 2018 (38)
[3]ALPPS在肝泡型包蟲(chóng)病中的應(yīng)用[J]. 王瑞濤,劉昌,張曉剛,萬(wàn)永,曲凱,顧靜嫻,郝萬(wàn)靜. 中華肝臟外科手術(shù)學(xué)電子雜志. 2018(02)
[4]Associating liver partition and portal vein ligation for staged hepatectomy for extensive alveolar echinococcosis:First case report in the literature[J]. Sami Akbulut,Egemen Cicek,Mehmet Kolu,Tevfik Tolga Sahin,Sezai Yilmaz. World Journal of Gastrointestinal Surgery. 2018(01)
[5]分期切除治療多發(fā)泡型肝包蟲(chóng)病的初步經(jīng)驗(yàn)[J]. 方丹,楊康明,陳哲宇,陳克霏,黃祥,嚴(yán)律南,李波,文天夫,王文濤,陳穎,吳泓,徐明清,馬智,楊家印,李智紅,魏永剛,魏耕富,黃紀(jì)偉,唐友銀,馮曦. 中國(guó)普外基礎(chǔ)與臨床雜志. 2017(07)
[6]離體肝切除聯(lián)合自體肝移植治療晚期肝泡型包蟲(chóng)病21例報(bào)道[J]. 楊先偉,黃斌,邱逸聞,杜丞淞,馮曦,魏永剛,沈舒,雷建勇,張中偉,趙繼春,陳哲宇,李波,文天夫,樊海寧,楊康明,魏耕富,嚴(yán)律南,王文濤. 中國(guó)普外基礎(chǔ)與臨床雜志. 2017(06)
[7]Hyperplasia vs hypertrophy in tissue regeneration after extensive liver resection[J]. Fabio Marongiu,Michela Marongiu,Antonella Contini,Monica Serra,Erika Cadoni,Riccardo Murgia,Ezio Laconi. World Journal of Gastroenterology. 2017(10)
[8]Mechanistic insights of rapid liver regeneration after associating liver partition and portal vein ligation for stage hepatectomy[J]. Demetrios Moris,Spyridon Vernadakis,Alexandros Papalampros,Michail Vailas,Nikolaos Dimitrokallis,Athanasios Petrou,Dimitrios Dimitroulis. World Journal of Gastroenterology. 2016(33)
[9]Application of 3D reconstruction for surgical treatment of hepatic alveolar echinococcosis[J]. Yi-Biao He,Lei Bai,Tuerganaili Aji,Yi Jiang,Jin-Ming Zhao,Jin-Hui Zhang,Ying-Mei Shao,Wen-Ya Liu,Hao Wen. World Journal of Gastroenterology. 2015(35)
[10]“減體積式病灶肝切除”治療晚期肝巨大泡型包蟲(chóng)病的臨床應(yīng)用[J]. 李作安,吐?tīng)柛砂Αぐ⒓?冉博,溫浩,邵英梅. 中國(guó)普通外科雜志. 2012(07)
本文編號(hào):3133433
【文章來(lái)源】:新疆醫(yī)科大學(xué)新疆維吾爾自治區(qū)
【文章頁(yè)數(shù)】:46 頁(yè)
【學(xué)位級(jí)別】:碩士
【部分圖文】:
門(mén)靜脈栓塞:[1A:門(mén)靜脈數(shù)字化造影;1B:門(mén)靜脈右支主干栓塞;1C:PVE術(shù)前PET-CT及病灶邊緣的測(cè)定;1D:PVE術(shù)前CT;1E:根治性術(shù)前CT]
圖 2 3D 數(shù)字化重建模型:[2A:病灶與肝實(shí)質(zhì)關(guān)系(淺黃色為病灶,藍(lán)色為肝組織);2B:全肝虛擬重建;2C:病灶與脈管的關(guān)系;1D:3D 虛擬手術(shù)后重建]Fig.2 3D reconstruction model:[2A: relationship between lesions and liver parenchyma (lightyellow for lesions, blue for liver tissue); 2B: liver virtual reconstruction; 2C: The relationshipbetween the lesion and the vessel; 2D: Reconstruction after virtual surgery ]
圖 3 患者隨訪期間剩余肝(FLR)體積容量變化Fig.3 Changes in FLR volume capacity during follow-up
【參考文獻(xiàn)】:
期刊論文
[1]肝泡型包蟲(chóng)病術(shù)后肝衰竭相關(guān)危險(xiǎn)因素分析及防治[J]. 許曉磊,王志鑫,任利,侯立朝,陽(yáng)丹才讓,周灜,王海久,鄧勇,樊海寧. 中華肝臟外科手術(shù)學(xué)電子雜志. 2018(06)
[2]肝泡型包蟲(chóng)病外科根治性治療的新理念與策略[J]. 王文濤,楊闖,嚴(yán)律南. 中華醫(yī)學(xué)雜志. 2018 (38)
[3]ALPPS在肝泡型包蟲(chóng)病中的應(yīng)用[J]. 王瑞濤,劉昌,張曉剛,萬(wàn)永,曲凱,顧靜嫻,郝萬(wàn)靜. 中華肝臟外科手術(shù)學(xué)電子雜志. 2018(02)
[4]Associating liver partition and portal vein ligation for staged hepatectomy for extensive alveolar echinococcosis:First case report in the literature[J]. Sami Akbulut,Egemen Cicek,Mehmet Kolu,Tevfik Tolga Sahin,Sezai Yilmaz. World Journal of Gastrointestinal Surgery. 2018(01)
[5]分期切除治療多發(fā)泡型肝包蟲(chóng)病的初步經(jīng)驗(yàn)[J]. 方丹,楊康明,陳哲宇,陳克霏,黃祥,嚴(yán)律南,李波,文天夫,王文濤,陳穎,吳泓,徐明清,馬智,楊家印,李智紅,魏永剛,魏耕富,黃紀(jì)偉,唐友銀,馮曦. 中國(guó)普外基礎(chǔ)與臨床雜志. 2017(07)
[6]離體肝切除聯(lián)合自體肝移植治療晚期肝泡型包蟲(chóng)病21例報(bào)道[J]. 楊先偉,黃斌,邱逸聞,杜丞淞,馮曦,魏永剛,沈舒,雷建勇,張中偉,趙繼春,陳哲宇,李波,文天夫,樊海寧,楊康明,魏耕富,嚴(yán)律南,王文濤. 中國(guó)普外基礎(chǔ)與臨床雜志. 2017(06)
[7]Hyperplasia vs hypertrophy in tissue regeneration after extensive liver resection[J]. Fabio Marongiu,Michela Marongiu,Antonella Contini,Monica Serra,Erika Cadoni,Riccardo Murgia,Ezio Laconi. World Journal of Gastroenterology. 2017(10)
[8]Mechanistic insights of rapid liver regeneration after associating liver partition and portal vein ligation for stage hepatectomy[J]. Demetrios Moris,Spyridon Vernadakis,Alexandros Papalampros,Michail Vailas,Nikolaos Dimitrokallis,Athanasios Petrou,Dimitrios Dimitroulis. World Journal of Gastroenterology. 2016(33)
[9]Application of 3D reconstruction for surgical treatment of hepatic alveolar echinococcosis[J]. Yi-Biao He,Lei Bai,Tuerganaili Aji,Yi Jiang,Jin-Ming Zhao,Jin-Hui Zhang,Ying-Mei Shao,Wen-Ya Liu,Hao Wen. World Journal of Gastroenterology. 2015(35)
[10]“減體積式病灶肝切除”治療晚期肝巨大泡型包蟲(chóng)病的臨床應(yīng)用[J]. 李作安,吐?tīng)柛砂Αぐ⒓?冉博,溫浩,邵英梅. 中國(guó)普通外科雜志. 2012(07)
本文編號(hào):3133433
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