超声在小肝癌切除术前及术中作用的探讨

Application of ultrasonography in little hepatic cancer resection

目的:评价术前及术中超声在小肝癌切除术中的作用。方法:采用Aloka-650与Aloka-500超声仪,腹部超声采用3.5 MHz探头,术中超声采用5 MHz或7.5 MHz探头,对术后病理证实的136例肝癌患者的术前CT、术前、术中超声和病理结果进行对比观察。结果:对照组68例共切除肿块71个,术前超声发现70个病灶(70/71,98%),术后1年复发率为13.2%(9/68)。试验组68例共切除肿块81个,术前CT共发现发现69个病灶(69/81,85%),术前超声与术中超声分别发现71个病灶(71/81,88%)与79个病灶(79/81,97%)(P<0.05),术后1年复发率为4.4%(3/68)。结论:术中超声能提高对细小结构的显示率,实施精准肝切除,力争多保留正常肝组织,防止术后肝衰竭,最大限度切除肝内病灶,减少肝癌术中病灶遗漏,对指导手术方案的制定与术中肿块的定位有很高的临床应用价值。

Objective：To evaluate the preoperative and intraoperative application of ultrasonography in little hepatic cancer resection.Methods：The apparatuses used before the operation was Aloka-650 and Aloka-500 with 3.5 MHz probe,probes were changed to be 5 MHz or 7.5 MHz during the procedure.Ultrasonography of 136 cases was compared with CT images and pathological tests.Results：Preoperative ultrasonography detected 70 lesions in 68 cases,while a total of 71 tumors were confirmed and removed（98%,70/71） with and re-emergence rate of 13.2%（9/68） according to a one-year follow up.In the experimental group,81 tumors in 68 cases were removed,of which,69 lesions（85%,69/81） were detected by CT,while 71（71/81,88%） and 79（79/81,97%） shown under preoperative and intraoperative ultrasonography（P0.05）,the re-emergence rate of the experimental group was 4.4%（3/68）.Conclusions：Ultrasonography can show lesions in tissues thus can help physicians to remove involved tissues while keep the normal tissues as much as possible.As guidance in hepatic cancer resection,ultrasonography shows significant values in finding the accurate location and making proper surgery procedures.