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为了深入了解基于CBCT的三维重建技术在原发性肝癌TACE治疗中的应用,本研究对在我院进行TACE治疗的原发性肝癌患者,分别采用基于CBCT的三维重建技术和常规的DSA技术进行分析比较。我们选取我院2013年1月~2015年10月确诊的67例原发性肝癌患者,采用随机数字表法分为CBCT组34例、血管造影(DAS组)33例,两组均采用TACE治疗,术中分别给予CBCT及三维重建、DSA技术进行手术指指导。研究表明:CBCT组对肿瘤供血动脉检出正确率、超选择动脉插管成功率、碘油在病灶中完全沉积率均高于DSA组(p<0.05);CBCT组的手术时间、辐射总剂量均高于DSA组(p<0.05);术后一个月复查,CBCT组CR 17.65%、PR 73.53%、SD 8.82%,DSA组CR 6.06%、PR 66.67%、SD 21.21%、PD 6.06%,两组比较差异具有统计学意义(p<0.05);术后一个月复查,CBCT组血清AFP水平低于DSA组(p<0.05);两组患者的KPS评分较本组术前均显著的提高(p<0.05),两组间的KPS评分差异无统计学意义(p>0.05)。我们的研究初步得出结论:基于CBCT的三维重建技术在原发性肝癌TACE治疗中较DSA技术能够更好的检出肿瘤的供血动脉、指导手术更加便捷和精确,能达到更好的手术效果。
In order to further understand the application of CBCT-based three-dimensional reconstruction in the treatment of primary hepatocellular carcinoma (TACE), this study used three-dimensional CBCT-based reconstruction and conventional DSA techniques in patients with primary hepatocellular carcinoma treated with TACE in our hospital. analyse and compare. We selected 67 patients with primary hepatocellular carcinoma diagnosed in our hospital from January 2013 to October 2015. The patients were divided into CBCT group (34 cases) and angiography group (33 cases) by random number table. TACE was used in both groups , Intraoperative were given CBCT and three-dimensional reconstruction, DSA technique for surgical guidance. The results showed that: CBCT group of tumor feeding artery detection accuracy, the success rate of superselective arterial catheterization, complete deposition of lipiodol in the lesions were higher than the DSA group (p <0.05); CBCT group operation time, total radiation dose (P <0.05). Compared with DSA group, the CBCT group had a CR of 17.65%, PR 73.53%, SD 8.82%, DS 6.06%, PR 66.67%, SD 21.21% and PD 6.06% (P <0.05). The level of serum AFP in CBCT group was lower than that in DSA group (p <0.05) at one month after operation. The KPS scores of both groups were significantly higher than those before operation (P <0.05) p <0.05). There was no significant difference in KPS scores between the two groups (p> 0.05). Our research concludes that the CBCT-based 3D reconstruction technique can detect the tumor’s feeding artery better than the DSA technique in the treatment of primary hepatocellular carcinoma (TACE), guiding the operation more conveniently and accurately, and achieving better surgical results .