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单用双极电凝断肝法与钳夹法在肝蒂横断法肝切除术中的比较

潘龙, 黄平, 杜成友, 李德卫

潘龙, 黄平, 杜成友, 李德卫. 单用双极电凝断肝法与钳夹法在肝蒂横断法肝切除术中的比较[J]. 肿瘤防治研究, 2015, 42(10): 1016-1019. DOI: 10.3971/j.issn.1000-8578.2015.10.014
引用本文: 潘龙, 黄平, 杜成友, 李德卫. 单用双极电凝断肝法与钳夹法在肝蒂横断法肝切除术中的比较[J]. 肿瘤防治研究, 2015, 42(10): 1016-1019. DOI: 10.3971/j.issn.1000-8578.2015.10.014
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PAN Long, HUANG Ping, DU Chengyou, LI Dewei. Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China[J]. Cancer Research on Prevention and Treatment, 2015, 42(10): 1016-1019. DOI: 10.3971/j.issn.1000-8578.2015.10.014
Citation: PAN Long, HUANG Ping, DU Chengyou, LI Dewei. Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China[J]. Cancer Research on Prevention and Treatment, 2015, 42(10): 1016-1019. DOI: 10.3971/j.issn.1000-8578.2015.10.014
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单用双极电凝断肝法与钳夹法在肝蒂横断法肝切除术中的比较

  • 400016 重庆，重庆医科大学附属第一医院肝胆外科

详细信息
    作者简介:

    潘龙（1986-），男，硕士，住院医师，主要从事肝脏肿瘤、胰岛移植的研究

    通讯作者:

    黄平，E-mail：huangpchina@sina.com

  • 中图分类号: R735.7

Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China

  • Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China

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    摘要
  • 摘要: 目的 通过与经典的钳夹法断肝比较，探讨单用双极电凝断肝法在肝蒂横断法肝切除术中的临床价值。方法 收集101例行肝蒂横断法肝切除术的原发性肝癌患者的临床资料。依据术中离断肝实质方法的不同，分为钳夹法组及双极电凝组。对比分析两组患者临床资料的差异。结果 两组患者术前Child-Pugh分级、吲哚菁绿15 min清除率（indocyanine green clearance rate at 15min, ICGR15）、合并肝硬化情况及手术时间差异无统计学意义（P>0.05）。两组患者的手术出血量[（488.89±268.76）ml vs.（390.00±209.82）ml，P=0.041）]、术中输血率（25.92% vs. 8.51%, P=0.023）、术后第一日白蛋白（albumin, ALB）水平[（25.69±4.27）ml vs.（27.57±4.11）ml, P=0.026]及术后24 h腹引量[60.00（10.00, 135.00）ml vs. 50.00（30.00, 80.00）ml P=0.039]间差异有统计学意义。结论 单独使用双极电凝断肝能够减少肝蒂横断法肝切除术出血量，降低输血率，术后白蛋白水平更高，渗出更少。单用双极电凝断肝应用于肝蒂横断法肝切除术较传统钳夹法断肝更有优势，具有临床推广价值。

     

    Abstract: Objective To evaluate the application of bipolar coagulation in hepatectomy with Glisson's pedicle transection method by comparing the efficacy of bipolar coagulation alone and classical clump crushing technique. Methods We collected clinical data of 101 primary hepatic carcinoma patients who received hepatectomy with Glisson's pedicle transection method. According to the use of bipolar coagulation, it was differed into bipolar coagulation alone group and clamp crushing technique group. Clinical details between two groups were compared. Results The two groups were similar in Child-Pugh classification, indocyanine green clearance rate at 15minutes(ICGR15), liver sclerosis, and operation time(P>0.05). There were significance differences in bleeding amount[(488.89±268.76) vs. (390.00±209.82)ml, P=0.041], blood transfusion rate(25.92% vs. 8.51%, P=0.023), serum albumin in the first postoperative day[(25.69±4.27) vs. (27.57±4.11)ml, P=0.026] and peritoneal drainage amount in 24h after operation[60.00(10.00, 135.00) vs. 50.00(30.00, 80.00)ml P=0.039]. Conclusion Compared with classical clump crushing technique, the application of bipolar coagulation in hepatectomy with Glisson's pedicle transection method is helpful in decreasing bleeding amount and blood transfusion rate, and patients have a higher serum albumin after operation.

     

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出版历程
  • 收稿日期:  2015-05-19
  • 修回日期:  2015-08-18
  • 刊出日期:  2015-10-24

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