胸部MSCTA技术辅助肺癌肺叶切除术的临床应用

  目的  探讨胸部多层螺旋CT血管成像（multi-slice computed tomography angiography，MSCTA）技术作为肺癌患者肺叶切除术前检查的临床应用价值。  方法  选择60例肺癌患者拟行肺叶切除术，随机分成两组。研究组:30例术前行胸部CT血管成像检查，利用容积再现（VR）技术获得肿瘤与肺动脉、支气管动脉及肺静脉的融合图像，了解上述血管与肿瘤的关系；对照组:30例行常规肺叶切除术。比较两组手术时间及手术出血量。  结果  研究组的手术时间（199±55.7）min vs.（231.5±51.2）min（P=0.02），手术出血量（318.33±99.6）mL vs.（431.7±89.5）mL（P < 0.01）与对照组比较均差异具有统计学意义，研究组手术时间与手术出血量均小于对照组。  结论  胸部多层螺旋CT血管成像技术作为肺叶切除术术前检查能够减少手术时间及手术出血量，具有重要的临床意义。 

Clinical application of multi-slice computed tomography angiogra-phy in pulmonary lobectomy of patients with lung cancer

  Objective   To explore the clinical value of chest multi-slice computed tomography angiography (MSCTA) as a preoperative examination for lung cancer patients undergoing pulmonary lobectomy.  Methods   Sixty lung cancer patients formed the study population and were randomly divided into 2 groups of 30 cases each. In the experimental group, CTA images of the tumors and pulmonary artery, bronchial artery, pulmonary vein were acquired, analyzed, and post-processed using VR to determine the anatomical relationship between vessels and tumors. Pulmonary lobectomy followed. Cases in the control group underwent pulmonary lobectomy without guidance by chest MSCTA. Operation times and amounts of operative blood loss were compared between the two groups.  Results   Significant differences between groups in terms of operation time (study group vs. control group, 199±55.7 vs. 231.5±51.2(min); P= 0.02) and amount of operative blood loss (study group vs. control group, 318.33±99.6 vs. 431.7±89.5(mL), P < 0.01) were observed. Values of operation time and amount of contrast agents in the study group were consistently lower than those in the control group.  Conclusion   Chest MSCTA can shorten the operation time and reduce the amount of operative blood loss during pulmonary lobectomy. Thus, the technique has significant clinical value.