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目的:探讨术中超声检查(IOUS)结合术前肝动脉造影(HAG)在原发性肝癌精准序贯治疗中的应用价值。方法:选择原发性肝癌207例,随机分为对照组(常规手术治疗组)81例及观察组(精准序贯治疗组)126例。比较两组术前影像学检查、术中及术后随访情况。结果:在发现直径<1.0cm肝内转移灶或卫星病灶方面,观察组显著优于对照组(P<0.05);在缩短手术时间、减少切除肝段数目及减小肝脏切除体积、减少术中失血及降低术后并发症发生率方面,观察组均非常显著优于对照组(P<0.01)。结论:IOUS结合术前HAG在发现原发性肝癌隐匿性或微小病灶及精准序贯治疗中具有重要价值。
Objective: To investigate the value of intraoperative ultrasound (IOUS) combined with preoperative hepatic arteriography (HAG) in the precise sequential treatment of primary liver cancer. Methods: A total of 207 primary hepatocellular carcinoma patients were randomly divided into control group (n = 81) and observation group (n = 126). Preoperative imaging examination, intraoperative and postoperative follow-up were compared between the two groups. Results: The observation group was significantly better than the control group (P <0.05) in finding intrahepatic metastases or satellite lesions of diameter less than 1.0cm; shortening the operation time, reducing the number of resected liver segments and reducing the volume of liver resection, and reducing the intraoperative Blood loss and reduce the incidence of postoperative complications, the observation group were significantly better than the control group (P <0.01). Conclusion: IOUS combined with preoperative HAG in the detection of occult or minimally invasive primary liver cancer and precise focus of sequential treatment of great value.