射频止血技术在肝切除术中的应用  

Radio.frequency hemostasis in hepatectomy

作　　者：耿建利[1] 李胜勇[1] 周忠晓[1] 孙运福[1] 于仲剑 高若辉 乔建文[1] 

机构地区：[1]威海市立医院肝胆外科,山东省264200

出　　处：《中华普通外科杂志》2011年第10期860-862,共3页Chinese Journal of General Surgery

摘　　要：目的探讨射频止血技术在肝切除术中的临床应用价值。方法回顾性总结2009年1月至2011年2月实施肝脏肿瘤切除患者60例。术中应用射频止血技术（raido-frequencyhemostasis，RFH）30例为射频组，传统钳夹法（clampcrushingmethod，CCM）30例作为对照组，两组患者年龄，性别，术前肝功能指标，病变大小等方面差异无统计学意义（P〉0．05）。记录患者手术时间、术中出血量、术后肝功能恢复情况，术后3d引流量，术后第1、7天ALT及T—BIL水平等方面进行对比研究。结果RFH组术中出血（219±62）ml明显少于CCM组（416±96）ml，差异有统计学意义（t=5．241，P〈0．05），RFH组未发生大出血，CCM组5例术中损伤肝静脉，3例出现大出血。术后3d引流量RFH组明显少于CCM组，术后第1、7天ATJ，r及T-BIL比较，RFH组明显小于CCM组（分别t=5．987，16．803，22．264，8．386，8．255，均P〈0．05）。术后肝功能恢复RFH组明显快于CCM组。结论射频止血技术在肝切除术中具备损伤小，出血量少，恢复快、安全性高等优势。Objective To evaluate radio-frequency hemostasis in hepatectomy. Methods From January 2009 to February 2011, the clinical data of 60 patients undergoing curative liver resection were divided into two groups using radio-frequency hemostasis （RFH） and clamp crushing method （CCM） respectively, RFH group （30 cases ） and CCM group （30 cases ）. There was no difference between the 2 groups regarding the age, sex. hepatic function and tumor size. Data regarding the intra-operative and postoperative courses of the patients were analyzed. Results No damage of hepatic vein occured in RFH group. Hepatic veins rupture occurred in 5 cases and massive bleeding occurred in 3 cases in CCM group. Intra-operative blood loss was significantly less in FRH group [ （219 ±62） ml ] than in CCM group [ （416 ±96） ml ] （ P 〈 0. 05 ）. The postoperative drainage volume in RFH group was significantly less than that in CCM group on the third postoperative day. The serum ALT and T-BIL in RFH group was significantly lower than that in CCM group on postoperative day 1 and day 7 （ separately t = 5. 987,16. 803,22. 264,8. 386, 8. 255, all P 〈 0. 05 ）. Postoperative hepatic function in RFH group was significantly better than that in CCM group. Conclusions The use of radio-frequency hemostasis in hepateetomy is less traumatic, of less bleeding, faster recovery than clamp crashing method.

关 键 词：肝肿瘤 肝切除术 止血技术 射频 

分 类 号：R735.7[医药卫生—肿瘤]