MPH对肝脏切除术后残肝断面止血效果的临床观察  

Clinical observation of hemostatic effection of microporous polysaccharide hemispheres on residual liver after hepatectomy

作　　者：谢斌[1] 唐春[1] 金世龙[1] 袁涛[1] 吴刚[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所肝胆外科,重庆400042

出　　处：《重庆医科大学学报》2009年第7期955-958,共4页Journal of Chongqing Medical University

摘　　要：目的:观察微孔多聚糖止血球(Microporous polysaccharide hemispheres,MPH)控制肝切除后残肝断面渗血及活动性出血的效果及安全性。方法:选择2006年10月至2007年8月在我院因肝脏肿瘤、肝内胆管结石需施行肝叶(段)切除术的患者60例,随机分为标准组、试验组1、试验组2、对照组,每组各15例。标准组采用常规外科手术方法(结扎、电凝)止血,试验组1使用MPH作为术中止血剂,试验组2使用止血纱布+MPH作为术中止血剂,对照组使用止血纱布作为止血剂。观察止血时间、术中及术后3d内的输血量及术后引流量。结果:标准组断面止血时间(2.98±1.05)min,术中输血量(400±200)ml,术后3d内输血量(400±200)ml,引流量(350±100)ml;试验组1断面止血时间(3.10±0.85)min,术中输血量(400±200)ml,术后3d内输血量(200±0)ml,引流量(200±100)ml;试验组2断面止血时间(3.20±1.52)min,术中输血量(200±200)ml,术后3d内输血量(200±0)ml,引流量(150±100)ml;对照组断面止血时间为(5.22±1.82)min,术中输血量(600±200)ml,术后3d内输血量(400±200)ml,引流量(400±150)ml。对照组止血成功率33%低于标准组和试验组,有显著性差异(P<0.05);各组均无不良反应发生。结论:MPH可以迅速、安全、有效地控制肝切除术后残肝断面渗血情况,结合止血纱布应用疗效更佳,且使用简便,值得在临床上推广使用。Objective：To evaluate the efficacy and safety of microporous polysaccharide hemispheres （MPH）in control of homostasis on residual liver after hepatectomy. Methods： 60 patients undergoing hepatectomy were randomized to four groups standard group, test group Ⅰ ,test groupⅡ ,and control group. Patients in standard group （15 patients）were treated with routine surgical technique to achieve homostasis.In test group Ⅰ （ 15 patients ）the MPH combined with absorbable haemostat were used as hemostatic agents while only the MPH was used in test group Ⅱ （ 15 patients ）. The other 15 patients were given absorbable haemostat as control group. The hemostasia time, the amount of blood transfusion during operation and three days after operations were evaluated, the other factors （ALT, Alb, biliary, PT）were also evaluated. Results： In the standard group, hemostasia time was （2.98± 1.05） min ; the blood transfusion amount was （400± 200） ml during operations and （400±200） ml three days after operations; the amount of drainage was （350± 100） ml. In the test group Ⅰ , hemostasia time was （3.10±0.85） min; the blood transfusion amount was （200 ± 0） ml during operations and （200 ±100） ml three days after operations; the amount of drainage was （200 ± 100） ml. In the test group Ⅱ, hemostasia time was （3.20 ± 1.52） min; the blood transfusion amount was （200±200） ml during operations and （200 ±0） ml three days after operations; the amount of drainage was （150± 100） ml, and while in control group, the corresponding results were （5.22± 1.82） min, （600 ± 200） ml, （400 ± 200） ml, （400 ± 150） ml, respectively. Satisfactory bleeding control was achieved in 5 patients with routline surgical technique, there was no significant diffterence among them. The incidence of hemostasis in control group （33%）was significantly lower than that in standard group （80%） and all test groups （73.3%, 66.7%, respectively）. No hemostatic c

关 键 词：微孔多聚糖止血球 肝切除术 止血 治疗 

分 类 号：P619.1[天文地球—矿床学]