选择性门静脉栓塞在晚期肝泡型包虫病治疗中的应用
发布时间：2021-04-12 14:07
目的:探讨选择性门静脉栓塞（PVE）在晚期肝泡型包虫病治疗中的疗效及应用价值。方法:对于新疆医科大学第一附属医院肝胆包虫科2014年9月至2018年4月期间行选择性门静脉栓塞术治疗的6例中晚期肝泡型包虫病患者的临床资料进行回顾性分析,患者中男性3例,女性3例,年龄区间为2168岁,平均年龄为40.67±19.31岁;术前腹部CTA明确诊断肝泡型包虫病,其中1例有肺部转移,1例合并慢性肝炎,术前患者Child-Pugh分级均为A级;三维肝脏重建影像技术,测量全部患者肝脏体积,病灶体积,残留肝脏体积,预计术后残余肝脏体积不足,不宜一期行根治性手术的肝泡型包虫病患者,在数字化造影引导下实施选择性门静脉栓塞术,待剩余肝体积代偿增生后行二期手术。分析患者人口统计学,一般临床病例资料,记录PVE前后剩余肝体积变化情况,PVE前后肝功能变化情况;PVE及二期手术方式,并发症;进行严密随访,记录二期术后剩余肝体积的变化情况,分析PVE的远期效应。计量资料的比较采用t检验,成组计量资料的比较采用两独立样本资料的t检验。结果:6例患者均成功实施PVE,1例患者出现腹痛,1例患者出现恶...
【文章来源】：新疆医科大学新疆维吾尔自治区
【文章页数】：46 页
【学位级别】：硕士
【部分图文】：
门静脉栓塞：[1A:门静脉数字化造影；1B：门静脉右支主干栓塞；1C：PVE术前PET-CT及病灶边缘的测定；1D：PVE术前CT；1E：根治性术前CT]
图 2 3D 数字化重建模型：[2A:病灶与肝实质关系（浅黄色为病灶，蓝色为肝组织）；2B：全肝虚拟重建；2C：病灶与脉管的关系；1D：3D 虚拟手术后重建]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 ]
图 3 患者随访期间剩余肝(FLR)体积容量变化Fig.3 Changes in FLR volume capacity during follow-up
【参考文献】：
期刊论文
[1]肝泡型包虫病术后肝衰竭相关危险因素分析及防治[J]. 许晓磊,王志鑫,任利,侯立朝,阳丹才让,周灜,王海久,邓勇,樊海宁. 中华肝脏外科手术学电子杂志. 2018(06)
[2]肝泡型包虫病外科根治性治疗的新理念与策略[J]. 王文涛,杨闯,严律南. 中华医学杂志. 2018 (38)
[3]ALPPS在肝泡型包虫病中的应用[J]. 王瑞涛,刘昌,张晓刚,万永,曲凯,顾静娴,郝万静. 中华肝脏外科手术学电子杂志. 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]分期切除治疗多发泡型肝包虫病的初步经验[J]. 方丹,杨康明,陈哲宇,陈克霏,黄祥,严律南,李波,文天夫,王文涛,陈颖,吴泓,徐明清,马智,杨家印,李智红,魏永刚,魏耕富,黄纪伟,唐友银,冯曦. 中国普外基础与临床杂志. 2017(07)
[6]离体肝切除联合自体肝移植治疗晚期肝泡型包虫病21例报道[J]. 杨先伟,黄斌,邱逸闻,杜丞淞,冯曦,魏永刚,沈舒,雷建勇,张中伟,赵继春,陈哲宇,李波,文天夫,樊海宁,杨康明,魏耕富,严律南,王文涛. 中国普外基础与临床杂志. 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)
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[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]“减体积式病灶肝切除”治疗晚期肝巨大泡型包虫病的临床应用[J]. 李作安,吐尔干艾力·阿吉,冉博,温浩,邵英梅. 中国普通外科杂志. 2012(07)
本文编号：3133433
【文章来源】：新疆医科大学新疆维吾尔自治区
【文章页数】：46 页
【学位级别】：硕士
【部分图文】：
门静脉栓塞：[1A:门静脉数字化造影；1B：门静脉右支主干栓塞；1C：PVE术前PET-CT及病灶边缘的测定；1D：PVE术前CT；1E：根治性术前CT]
图 2 3D 数字化重建模型：[2A:病灶与肝实质关系（浅黄色为病灶，蓝色为肝组织）；2B：全肝虚拟重建；2C：病灶与脉管的关系；1D：3D 虚拟手术后重建]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 ]
图 3 患者随访期间剩余肝(FLR)体积容量变化Fig.3 Changes in FLR volume capacity during follow-up
【参考文献】：
期刊论文
[1]肝泡型包虫病术后肝衰竭相关危险因素分析及防治[J]. 许晓磊,王志鑫,任利,侯立朝,阳丹才让,周灜,王海久,邓勇,樊海宁. 中华肝脏外科手术学电子杂志. 2018(06)
[2]肝泡型包虫病外科根治性治疗的新理念与策略[J]. 王文涛,杨闯,严律南. 中华医学杂志. 2018 (38)
[3]ALPPS在肝泡型包虫病中的应用[J]. 王瑞涛,刘昌,张晓刚,万永,曲凯,顾静娴,郝万静. 中华肝脏外科手术学电子杂志. 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]分期切除治疗多发泡型肝包虫病的初步经验[J]. 方丹,杨康明,陈哲宇,陈克霏,黄祥,严律南,李波,文天夫,王文涛,陈颖,吴泓,徐明清,马智,杨家印,李智红,魏永刚,魏耕富,黄纪伟,唐友银,冯曦. 中国普外基础与临床杂志. 2017(07)
[6]离体肝切除联合自体肝移植治疗晚期肝泡型包虫病21例报道[J]. 杨先伟,黄斌,邱逸闻,杜丞淞,冯曦,魏永刚,沈舒,雷建勇,张中伟,赵继春,陈哲宇,李波,文天夫,樊海宁,杨康明,魏耕富,严律南,王文涛. 中国普外基础与临床杂志. 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]“减体积式病灶肝切除”治疗晚期肝巨大泡型包虫病的临床应用[J]. 李作安,吐尔干艾力·阿吉,冉博,温浩,邵英梅. 中国普通外科杂志. 2012(07)
本文编号：3133433
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