【摘要】 目的 分析术前多层螺旋CT三维重建（3D-MSCT）联合术中吲哚菁绿（ICG）荧光成像的腹腔镜下右半结肠切除术在结肠癌（CC）患者中的应用效果。方法 采用随机数字表法将122例结肠癌患者分为对照组和研究组，每组61例。对照组术前采用常规CT检查行传统腹腔镜手术治疗，研究组采用术前3D-MSCT检查联合术中ICG荧光成像的腹腔镜手术治疗。比较两组患者手术相关指标、胃肠功能指标[胃动素（MTL）、胃泌素（GAS）、抑胃肽（GIP）]、应激指标[皮质醇（Cor）、去甲肾上腺素（NE）、促肾上腺皮质激素（ACTH）]、术后并发症发生情况及短期预后。结果 研究组患者术中出血量明显少于对照组，手术时间明显短于对照组，淋巴结清扫数目明显多于对照组，差异均有统计学意义（P﹤0.01）。术后，两组患者MTL、GAS、GIP水平均较术前降低，但研究组患者MTL、GAS、GIP水平均高于对照组，差异均有统计学意义（P﹤0.05）。术后，两组患者Cor、NE、ACTH水平均较术前升高，但研究组患者Cor、NE、ACTH水平均低于对照组，差异均有统计学意义（P﹤0.05）。两组患者术后并发症总发生率比较，差异无统计学意义（P﹥0.05）；术后1周，研究组患者总有效率高于对照组（P﹤0.05）；随访6个月，研究组患者复发率低于对照组（P﹤0.05）。结论 术前3D-MSCT结合术中ICG荧光成像的腹腔镜右半结肠切除术在治疗右半结肠癌患者中显示出改善手术相关指标、减轻应激反应、改善胃肠功能等优势，且具有一定的安全性，短期预后良好。更多还原

【Abstract】 Objective To analyze the application effect of multi-slice spiral CT 3D reconstruction(3D-MSCT) combined with intraoperative indocyanine green(ICG) fluorescence imaging in laparoscopic right hemicolectomy for patients with colon cancer(CC). Method A total of 122 patients with CC were randomly divided into the control group and the study group by random number table method, with 61 cases in each group. The control group was treated with conventional laparoscopic surgery by conventional CT examination before operation, and the study group was treated with laparoscopic surgery by preoperative 3D-MSCT examination combined with intraoperative ICG fluorescence imaging. The operation-related indexes, gastrointestinal function indexes [motilin(MTL), gastrin(GAS), gastric inhibitory polypeptide(GIP)], stress indexes [cortisol(Cor), norepinephrine(NE), adrenocorticotropic hormone(ACTH)], postoperative complications and short-term prognosis were compared between the two groups. Result The blood loss in the study group was significantly less than that in the control group, the operation time was significantly shorter than that in the control group,the number of lymph node dissection was significantly more than that in the control group, the differences were statistically significant(P<0.01). After operation, the levels of MTL, GAS and GIP in the two groups were lower than those before operation, but the levels of MTL, GAS and GIP in the study group were higher than those in the control group, and the differences were statistically significant(P<0.05). After operation, the levels of Cor, NE and ACTH in the two groups were higher than those before operation, but the levels of Cor, NE and ACTH in the study group were lower than those in the control group, and the differences were statistically significant(P<0.05). There was no significant difference in the total incidence of postoperative complications between the two groups(P>0.05). At 1 week after operation, the total effective rate of the study group was higher than that of the control group(P<0.05). After 6 months of follow-up, the recurrence rate of the study group was lower than that of the control group(P<0.05). Conclusion Preoperative 3D-MSCT combined with intraoperative ICG fluorescence imaging for laparoscopic right hemicolectomy in the treatment of patients with right colon cancer shows the advantages of improving surgery-related indicators, reducing stress response and improving gastrointestinal function. It is safe and has a good short-term prognosis.更多还原