【摘要】 目的:探讨多层螺旋CT肠系膜血管成像(Multislice spiral computed tomography angiography of mesenteric vessels,MSCTA)在结直肠癌腹腔镜手术中的应用价值。方法:选择我院2019年1月至2020年12月收治的40例结直肠癌患者,随机分为观察组(20例,采用MSCTA技术)和对照组(20例,采用常规CT平扫及增强扫描),比较两组患者的术前肠系膜血管成像与手术符合率、术中和术后各项临床指标和术后并发症发生率。结果:(1)观察组20例患者术中肠系膜血管及分支走行、分布与开口变异情况与术前MSCTA检查符合率为100.00%。对照组20例患者术中肠系膜血管及分支走行、分布与开口变异情况与术前CT平扫增强符合率为85.00%,漏诊3例血管变异。(2)对比两组术中、术后临床指标发现:观察组术中出血量、腹腔引流量、肛门排气时间优于对照组(P<0.05);淋巴结清扫个数和住院时间方面,两组差异均无统计学意义(P>0.05)。(3)观察组并发症发生率(10.00%)低于对照组(25.00%)(P<0.05)。结论:在结直肠癌腹腔镜手术前使用MSCTA肠系膜血管评估,可对肠系膜血管及分支走行、分布与开口变异情况做出准确判断,有效保障患者安全,提高手术治疗效果。更多还原

【Abstract】 Objective :To explore the application value of multislice spiral computed tomography angiography of mesenteric vessels(MSCTA)in laparoscopic colorectal cancer surgery.Methods :A total of 40 cases of colorectal cancer patients diagnosed in our hospital between January 2019 and December 2020 were randomly divided into observation group(20 cases,using the MSCTA and three-dimensional reconstruction check)and control group(20 cases,using conventional CT examination),the comparison of two groups of patients with preoperative image coincidence rate,intraoperative and postoperative clinical indicators and the incidence of postoperative complications were performed.Results :(1)Preoperative CT image analysis of the two groups of patients showed that:the coincidence rate of intraoperative mesenteric vessels and branch direction of 20 patients in the observation group and preoperative MSCTA examination results was 100. 00%. The coincidence rate of intraoperative mesenteric vessels and branches of 20 patients in the control group and preoperative CT examination results was 85. 00%,and 3 cases of vascular variation were missed.(2)The comparison of intraoperative and postoperative clinical indicators between the two groups showed that the intraoperative blood loss,abdominal drainage volume and anal exhaust time in the observation group were better than those in the control group(P<0. 05);There was no significant difference in the number of lymph node dissected and the length of hospital stay between the two groups(P>0. 05).(3)The incidence of complications in the observation group(10. 00%)was lower than that in the control group(25. 00%,P<0. 05).Conclusion:The application of MSCTA to evaluate the mesenteric vessels before laparoscopic colorectal surgery can estimate effectively the variation of arterial origin and anastomotic branch,so as to guarantee the overall treatment effect of the operation,and can actively improve the treatment outcome and prognosis of patients.更多还原