中文摘要：

目的 探讨三维可视化技术辅助的肝切除术治疗原发性肝癌的疗效.方法 前瞻性非随机地将2013年9月至2014年12月南方医科大学珠江医院收治的108例原发性肝癌患者分为三维可视化技术辅助的肝切除组（3D组,55例）和常规肝切除组（常规组,53例）.记录两组患者的手术时间、失血量、输血量及术后第1、3、5天肝功能生化指标变化和术后并发症发生情况.采用返院复查或电话的方式进行随访.符合正态分布的计量资料行两独立样本t检验,不符合正态分布的行非参数Mann-Whitney U检验;计数资料采用χ^2检验或Fisher确切概率检验.结果 3D组和常规组患者术中输血量分别为300 ml（200 ～ 600ml）和400 ml（300 ～700 ml）（χ^2=-2.609,P=0.009）,术中失血量分别为400 ml（250～600 ml）和550 ml（400～800 ml）（χ^2=-2.277,P=0.023）,手术时间分别为（247±57） min和（262±53） min（χ^2=-1.787,P=0.074）.3D组术后第1、3、5天ALT、AST、总胆红素水平均低于常规组（χ^2=-5.740 ～-0.692,P值均＜0.05）.3D组术后第3、5天血清清蛋白水平高于常规组[（33.0±5.6） g/L比（31.2±4.1）g/L,t=1.922,P＜0.05;（36.7±4.4） g/L比（34.7±4.2）g/L,t=2.573,P＜0.05].3D组和常规组术后总体并发症发生率分别为10.9％和30.1％（χ^2 =6.185,P=0.013）,术后住院天数分别为（12.6 ±3.6）d和（14.4±3.5）d（χ^2=-3.384,P =0.001）,肿瘤标本切缘阳性率分别为0和9.4％（Fisher检验：P =0.026）,术后1年肿瘤复发率分别为22.2％和37.5％ （P＞0.05）,术后1年生存率分别为82.2％和77.5％ （P＞0.05）.两组均无围手术期死亡.结论 三维可视化技术辅助的肝切除术治疗原发性肝癌可减少手术损伤、降低术后并发症发生率,提高手术的有效性和安全性,使患者获得较好的预后.

英文摘要：

Objective To study the clinical efficacy of three dimensional visualization technique assisted hepatectomy for the treatment of primary liver cancer.Methods A total of 108 primary liver cancer patients who had been admitted to Zhujiang Hospital of Southern Medical University from September 2013 to December 2014 were assigned to three dimensional visualization technique assisted hepatectomy group （n =55） and routine hepatectomy group （n =53） according to different methods of hepatectomy.The observed variable in two groups as fellow：the operative time,intraoperative blood loss,intraoperative blood transfusion,the change of postoperative liver function and biochemical indicators in 1,3,5 days,postoperative complication.The patients were followed up via-return visit or telephone.A student＇s t test was used to compare continuous parametric variables,and the Mann-Whitney U test was used to compare non-parametric or discrete variables,as appropriate.Categorical data were compared using the Chi-square test or Fisher＇s exact test.Results In 3D group and routine hepatectomy group,the patients＇intraoperative blood transfusion volume were 300 ml（200-600ml）and400ml（300-700ml）（χ^2=-2.609,P=0.009） respectively,intraoperative blood loss volume were 400 ml（250-600 ml） and 550 ml（400-800 ml）（χ^2 =-2.277,P =0.023）,the operative time were （247 ± 57） min and （262 ± 53） min （χ^2 =-1.787,P =0.074）,the deterioration of the mainly liver function indicators peak in routine hepatectomy group were higher than that in 3D group （P 〈0.05）.The ALT,AST,TBIL in 3D group were lower than that in routine group on postoperative day 1,3,5,respectively（χ^2=-5.740--0.692,all P 〈 0.05）.The ALB in 3D group was higher than that in routine group on postoperative day 3,5 （（33.0±5.6） g/L vs.（31.2 ± 4.1） g/L,（36.7 ± 4.4） g/L vs.（34.7 ± 4.2） g/L） （t =1.922-2.573,both P 〈 0.05）.In 3D group and routine hepatectomy group,the incidence of postoperative complications