吸切法断肝与阻断肝门血流刀柄断肝的比较研究  

The comparative study of hepatectomy bymethods of sucking resection and by scalpel handle resection through blocking hepatopor-tal hlood stream

作　　者：于仁忠[1] 孙传春[1] 张玉利 徐士佳 刘盛仁 刘卓吾[1] 钱焕德 杜宗仁 刘益斌 

机构地区：[1]山东省莱阳卫生学校,烟台市莱阳中心医院

出　　处：《中华实验外科杂志》1994年第6期363-364,共2页Chinese Journal of Experimental Surgery

摘　　要：通过对２０只活体犬进行吸切法断肝与阻断肝门血流用刀柄断肝的对照实验，结果提示：实验组在不控制肝脏血供条件下用吸切器断肝的单纯断肝时间（３′３２″）和断肝止血总时间（９′４９″）均较阻断肝门血流用刀柄断肝的对照组（７′２７″、１７′２８″）显著快（Ｐ＜０．０１）；实验组断肝失血量（６３．６ｍｌ）与对照组（５２．３ｍｌ）比较无明显差异（Ｐ＞０．０５）；实验组断肝时平均动脉血压的最低平均值（１２．７ｋＰａ）较对照组（６．５ｋＰａ）改变轻微，差异非常显著（Ｐ＜０．０１）；术中心电图和术后肝功能以及肝、脾脏的病理改变实验组均较对照组轻，且术后并发症少，恢复快。这对伴有肝硬化者更有着极其重要的意义。Comparative experimental hepatectomieswere performed by using sucking resectoinmethod and scalpel handle resection methodthrough blocking the hepatoportal bloodstream in 20 living dogs. The results showedthat the time consumed for hepatectomy aloneby using sucking resection method withoutblocking the hepatoportal blood stream in theexperimental group(3 minutes 32 seconds)and the total time for hepatectomy together withstopping bleeding(9 minutes 49 seconds)wassignificantly shorter than that of the scalpelhandle resection method through blockinghepatoportal blood stream in the controlledgroup(7 minutes 27 seconds and 17 minutes 28seconds respectively)(P<0.01).There wasno significant difference comparing the bloodloss in the experimental group(63.6ml)andthat in the controlled group(52.3ml)(P>0.05).During hepatectomized,the lowestmean arterial blood pressure for the experi-mental group(12.7kPa)was significant higherthan the coutrolled group(6.5kPa)P<0.01.There were less changes in EKG during theoperations,in postoperative liver function andthe pathological changes in the liver andspleen in the experimental group.than in thecontrolled group.Less postoperative complica-tions and quicker recovery were also observedin the experimental group as well.This indi-cates that besides the procedures for hepatec-tomy are greatly simplified by using the suck-ing resection method,more important are it isnot necessarv to block the hepatoportal bloodstream;less changes in the circulation dynam-ics;the possibility of avoiding hepatocyte is-chemia and reperfusion damage-Thereby pro-moting the safety of the operation;decreasingthe postoperative complications,significantlyimportant for those accompanying cirrhosis.

关 键 词：肝脏吸切器 吸切法断肝术 断肝 动物实验 

分 类 号：R657.3[医药卫生—外科学]