摘要
目的:探讨增强现实(AR)导航联合七步两枪法在3D腹腔镜缩小右半肝切除术中的应用价值。方法:简单随机化法将2019年1月至2022年1月我院收治的104例肝癌患者分为标准组和改良组,每组各52例。标准组实施3D腹腔镜右半肝切除术,改良组采用AR导航联合七步两枪法行3D腹腔镜缩小右半肝切除术。比较两组手术一般情况、术后康复进程、血红蛋白、白蛋白、肝功能[总胆红素(TBil)、谷草转氨酶(AST)、谷丙转氨酶(ALT)]、凝血功能[凝血酶原时间(PT)、凝血酶原活动度(PA)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)]、免疫球蛋白[免疫球蛋白G(IgG)、IgA、IgM]、并发症及随访1年复发率。结果:改良组手术时间、术后肠鸣音恢复时间、术后排气时间、术后下床活动时间、术后置管时间、住院时间均短于标准组,术中出血量、肝实际切除体积低于标准组,剩余肝体积高于标准组(P<0.05);改良组术后3d、术后5d血红蛋白、白蛋白、PA、FIB高于标准组,TBil、AST、ALT、PT、APTT低于标准组(P<0.05);改良组术后3d、术后5d的IgG、IgA、IgM高于标准组(P<0.05);改良组并发症总发生率、随访1年复发率分别为1.92%(1/52)、3.92%(2/51),与标准组的5.77%(3/52)、8.00%(4/50)比较,无显著差异(P>0.05)。结论:AR导航联合七步两枪法能优化3D腹腔镜缩小右半肝切除术路径,减少术中出血及肝切除体积,减轻肝功能和免疫功能损伤,改善患者凝血功能,缩短患者恢复进程,具有较好安全性及近中期效果。
Objective:To investigate the value of augmented reality(AR)navigation combined with the seven-step,two-shot method in 3D laparoscopic reduction of the right hemicolectomy.Methods:A simple randomization method was used to divide 104 patients with hepatocellular carcinoma admitted to our hospital from January 2019 to January 2022 into a standard group and a modified group,with 52 patients in each group.The standard group underwent 3D laparoscopic right hemicolectomy,and the modified group underwent 3D laparoscopic reduced right hemicolectomy using AR navigation combined with the seven-step two-shot method.The two groups were compared in terms of the general condition of surgery,postoperative recovery process,hemoglobin,albumin,liver function[total bilirubin(TBil),glutamic aminotransferase(AST),glutamic aminotransferase(ALT)],coagulation function[prothrombin time(PT),prothrombin activity(PA),activated partial thromboplastin time(APTT),fibrinogen(FIB)],immunoglobulin[immune globulin G(IgG),IgA,IgM],complications and recurrence rate at 1 year follow-up.Results:The operation time,recovery time of postoperative bowel sounds,postoperative exhaustion time,postoperative bed activity time,postoperative tube placement time,and hospital stay were shorter in the modified group than in the standard group,and the intraoperative bleeding and actual volume of liver resection were lower than in the standard group,and the remaining liver volume was higher than in the standard group(P<0.05);hemoglobin,albumin,PA,and FIB were higher in the modified group than in the standard group at 3d and 5d postoperatively,and TBil,AST,ALT,PT,APTT were lower than those in the standard group(P<0.05).The IgG,IgA,and IgM at 3d and 5d postoperatively were higher in the modified group than in the standard group(P<0.05);the overall complication rate and recurrence rate at 1 year follow-up in the modified group were 1.92%(1/52)and 3.92%(2/51),respectively,which were not significantly different from 5.77%(3/52)and 8.00%(4/50)in the standard group(P>0.05).Conclusion:AR navigation combined with the seven-step,two-shot method can optimize the path of 3D laparoscopic reduction of right hemicolectomy,reduce intraoperative bleeding and hepatic resection volume,mitigate liver function and immune function damage,improve patients'coagulation function,and shorten patients'recovery process,with better safety and near-to mid-term results.
作者
吴永融
刘振
郝树青
韦敏
WU Yongrong;LIU Zhen;HAO Shuqing(Liuzhou People's Hospital,Guangxi Liuzhou 545002,China)
出处
《河北医学》
CAS
2023年第7期1201-1208,共8页
Hebei Medicine
基金
广西壮族自治区卫生健康委员会自筹经费科研课题,(编号:Z-B20221390)。
关键词
增强现实
腹腔镜
肝切除术
凝血功能
肝功能
免疫球蛋白
Augmented reality
Laparoscopy
Hepatectomy
Coagulation
Liver function
Immunoglobulin
作者简介
通讯作者:刘振。
