目的 探讨CT血管造影（CTA）在腹腔镜辅助结肠癌根治术前检查中的价值。方法 选取2013年5月至2016年7月在河北医科大学第一医院就诊并拟行腹腔镜结肠癌根治术患者58例,按术前检查方式的不同分为CTA组35例与CT组23例。术前所有患者均行腹部CT检查,CTA组患者加用容积再现（VR）技术显示肠系膜主要血管。手术指标比较：手术时间、术中出血量、淋巴结检出个数及术后排气时间;术后并发症比较：切口感染、吻合口漏、术后肠梗阻。结果 CTA组患者手术所需时间较CT组远远缩短（t=-2.115,P=0.039）;CTA组术中出血量较CT组显著减少（t=-2.349,P=0.031）;CTA组术中淋巴结检出个数与CT组的差异无统计学意义（t=1.813,P=0.076）;CTA组术后排气时间与CT组相比差异无统计学意义（t=-0.881,P=0.391）。CTA组与CT组患者术后切口感染发生率方面的差异无统计学意义（Χ^2=0.011,P〉0.05）,术后肠梗阻发生率方面的差异无统计学意义（Χ^2=0.046,P〉0.05）;CTA组没有出现吻合口漏,CT组中有3例（13.04%）出现,但差异无统计学意义（Χ^2=2.522,P〉0.05）。结论 通过CT血管造影,术前即掌握肠系膜血管的走行,不仅缩短了手术时间,还可减少不必要的血管损伤出血。术前了解肠系膜血管及淋巴结的处理范围,可能有利于降低术后并发症的发生。
Objective To explore the value of CTA in the preoperative examination of laparoscopic assisted colon cancer. Methods Fifty-eight patients with colon cancer who intended to treat with laparoscopic colon cancer radical resection from May 2013 to July 2016 were divided into two groups according to the different methods of preoperative examination. All patients received preoperative abdominal CT examination and the CTA group patients combined with VR technology could show the major mesenteric major blood vessels. Surgical indicators were comparied including operation time, intraoperative blood loss, lymph node number and postoperative exhaust time. Postoperative complications were including incision infection, anastomosis anastomotic fistula and postoperative intestinal obstruction. Results Patients in the CTA group had a shorter duration of operation than the CT group （t=-2.115, P=0.039）. The intraoperative blood loss of CTA group was significantly lower than that of CT group （t=-2.349, P=0.031）. The number of lymph nodes in the CTA group had no significant difference with that in significant difference in the postoperative exhaust time and postoperative intestinal obstruction between CTA group and the CT group （t=1.813, P=0.076）. There had no incidence of postoperative incision infection and CT group （P 〉 0.05）. There was no anastomotic fistula in the CTA group and 3 （13.04%） anastomotic fistulas in the CT group （X2=2.522, P 〉 0.05）, Conclusion CT angiography, mastering of mesenteric vessels of preoperative, not only shortened the operation time, but also reduced the unnecessary vascular injury bleeding, preoperative knowledge of mesenteric blood vessels and lymph node processing range, which was possibly helpful to reduce the occurrence of postoperative complications.