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计算机辅助手术系统在小儿肝血管瘤中的应用价值。

Application value of computer-assisted surgery system in pediatric hepatic hemangioma.

机构信息

Department of Pediatric Surgery, The Affiliated Hospital of Qingdao University, Qingdao, 266000, China.

Department of Pediatric Surgery, Yijishan Hospital of Wannan Medical College, Wannan Medical College, Wuhu, 241000, China.

出版信息

Pediatr Surg Int. 2021 Nov;37(11):1575-1583. doi: 10.1007/s00383-021-04972-5. Epub 2021 Jul 26.

Abstract

PURPOSE

To explore the treatment of pediatric hepatic hemangioma and the role of the Hisense computer-assisted surgery (Hisense CAS) system in diagnosis and treatment.

METHODS

We collected the clinical and follow-up data of all pediatric hepatic hemangioma cases in our pediatric surgery department from March 2008 to March 2021 for retrospective analysis. The Hisense CAS system was used to create three-dimensional (3D) reconstructions based on computed tomography data.

RESULTS

There were 71 patients, mainly infants (prenatal to 39 months). There were more males than females (42 vs. 29), and the alpha-fetoprotein level was significantly increased in 8 cases. 3D reconstruction by the Hisense CAS system showed that hepatic artery tracking was helpful for the differential diagnosis of pediatric hepatic hemangioma. Twenty-three children treated with propranolol showed significant differences in the tumour diameter, volume, and tumour-to-liver volume ratio after treatment (all P < 0.05). Compared with early surgical treatment, the curative effect of this approach was obvious.

CONCLUSION

As a non-surgical treatment for symptomatic pediatric hepatic hemangioma, propranolol can replace surgical resection to a certain extent and reduce the proportion of children who need surgical intervention. Hisense CAS has advantages in evaluating the tumour volume before and after propranolol treatment. The liver volume and the liver tumour volume percentage provide new perspectives for evaluating the tumour outcome.

摘要

目的

探讨小儿肝血管瘤的治疗方法及海信计算机辅助手术(Hisense CAS)系统在诊治中的作用。

方法

回顾性分析 2008 年 3 月至 2021 年 3 月本科收治的小儿肝血管瘤患儿的临床及随访资料,采用海信 CAS 系统基于 CT 数据进行三维(3D)重建。

结果

共 71 例患儿,均为婴儿(产前至 39 个月),男多于女(42 例比 29 例),8 例甲胎蛋白水平明显升高。海信 CAS 系统 3D 重建示肝动脉追踪有助于小儿肝血管瘤的鉴别诊断。23 例行普萘洛尔治疗的患儿治疗后肿瘤直径、体积、瘤体与肝脏比值均有显著差异(均 P<0.05),疗效明显优于早期手术治疗。

结论

普萘洛尔作为小儿肝血管瘤有症状患儿的非手术治疗方法,可在一定程度上替代手术切除,减少需要手术干预的患儿比例。海信 CAS 系统在评价普萘洛尔治疗前后肿瘤体积方面具有优势,肝体积及肝肿瘤体积百分比为评估肿瘤疗效提供了新视角。

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