中国实用外科杂志

中国实用外科杂志

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ICG分子荧光影像技术用于肝脏肿瘤手术安全性和有效性Meta分析

张玮琪，卓嘉明，方驰华   

  1. 南方医科大学珠江医院肝胆一科 广东省数字医学临床工程技术研究中心，广东广州 510282
  • 出版日期:2019-07-01 发布日期:2019-07-10

  • Online:2019-07-01 Published:2019-07-10

摘要：

目的    系统评价吲哚菁绿（ICG）分子荧光影像技术应用于肝脏肿瘤手术的安全性和有效性。方法    计算机检索PubMed、EMbase、The Cochrane Library、CNKI、万方和维普数据库，检索有关肝脏肿瘤手术治疗应用ICG分子荧光影像技术的研究，检索时间均为建库至2019年6月。筛选文献、提取资料后，采用RevMan 5.3软件进行Meta分析。结果  共纳入10项研究、803例病人，其中采用ICG分子荧光影像技术辅助肝脏肿瘤切除（试验组）328例，未采用者（对照组）475例。Meta分析结果显示，与对照组比较，试验组输血率（OR=0.42，95%CI=0.22~0.80，P=0.008）、术后并发症发生率（OR=0.49，95%CI=0.28~0.85，P=0.01）降低，切缘阴性率提高（OR=3.22，95%CI=1.09~9.51，P=0.03）；在围手术期出血量、手术时间以及住院时间方面差异均无统计学意义（均P>0.05）。结论    ICG分子荧光影像技术应用于肝脏肿瘤的精准诊疗，可有效降低输血率、术后并发症发生率，提高切缘阴性率。

关键词: ICG分子荧光影像, 肝脏肿瘤, 肝切除术, Meta分析, 系统评价, 队列研究

Abstract:

Indocyanine green fluorescence imaging for precise diagnosis and treatment of liver neoplasms: A Meta-analysis        ZHANG Wei-qi，ZHOU Jia-ming，FANG Chi-hua. The First Department of Hepatobiliary Surgery，Zhujiang Hospital，Southern Medical University；Guangdong Provincial Clinical and Engineering Center of Digital Medicine，Guangzhou 510282，China
Corresponding author：FANG Chi-hua，E-mail：fangch_dr@163.com
Abstract    Objective    To systematically review the safety and effectiveness of indocyanine green (ICG) fluorescence imaging for precise diagnosis and treatment of liver neoplasms. Methods    PubMed，EMbase，The Cochrane Library，CNKI，WanFang Data and VIP databases were electronically searched to collect cohort Studies which involved ICG fluorescence imaging for precise diagnosis and treatment of liver neoplasms. The retrieval time was from inception of the database to June 2019. Screened the literatures，extracted data，and Meta-analysis was performed by using RevMan 5.3 software. Results    10 studies were finally included involving 803 patients，with 328 cases in ICG molecular fluorescence imaging group and 475 patients in the control group. The results of meta-analysis showed that in ICG fluorescence imaging group，compared with the control group，the blood transfusion rate was decreased（OR=0.42，95%CI 0.22~0.80，P=0.008），the rate of negative incision margin was increased（OR=3.22，95%CI 1.09~9.51，P=0.03），the incidence of postoperative complications was decreased（OR=0.49，95%CI 0.28~0.85，P=0.01）. However，there was no statistical differences between the two groups in terms of perioperative blood loss，operation time or hospitalization time（all P＞0.05）. Conclusion    The application of ICG fluorescence imaging in precise diagnosis and treatment of liver neoplasms can effectively reduce the incidence of blood transfusion，the incidence of postoperative complications，and increase the rate of negative incision margin.

Key words: ICG fluorescence imaging, indocyanine green, liver neoplasms, hepatectomy, Meta-analysis, systematic review, cohort studies