射频凝血器在原发性肝癌切除术中的应用  

Application of radiofrequency device in liver resection for the treatment of primary liver cancer

作　　者：王铮[1] 徐军[1] 张东[1] 仵正[1] 陈变玲[1] 马清涌[1] 

机构地区：[1]西安交通大学医学院第一附属医院肝胆外科,710061

出　　处：《中华消化外科杂志》2012年第4期371-373,共3页Chinese Journal of Digestive Surgery

基　　金：国家自然科学基金（81071877）

摘　　要：目的探讨射频凝血器在原发性肝癌切除术中的应用价值。方法回顾性分析2010年1月至2012年2月西安交通大学医学院第一附属医院收治的82例行手术切除的原发性肝癌患者的临床资料，根据其手术方式不同将患者分为射频止血肝切除组（41例）和常规钳夹肝切除组（41例），通过对两组患者的临床资料进行分析，评价射频凝血器的应用价值。计量资料采用t检验，计数资料采用#检验。结果射频止血肝切除组平均手术时间（77±28）min，比常规钳夹肝切除组的（129±34）min明显缩短（t=7．432，P〈0．05）；射频止血肝切除组肝门阻断4例，较常规钳夹肝切除组的23例明显减少（X^2=19．934，P〈0．05）；射频止血肝切除组和常规钳夹肝切除组术中出血量分别为（241±214）ml和（751±421）ml，术中输血患者比例分别为15％（6／41）和49％（20／41），两者比较，差异均有统计学意义（t=6．920，）（X^2=11．038，P〈0．05）。射频止血肝切除组和常规钳夹肝切除组在术后出血发生率、术后胆汁漏发生率方面比较，差异无统计学意义（妒=0．213，1．822，P〉0．05）；射频止血肝切除组术后住院时问为（9±4）d，比常规钳夹组的（12±7）d明显减少（t=2．368，P〈0．05）。两组均无围手术期死亡患者。结论新型手术辅助器械射频凝血器能够有效地控制出血、减少手术时间，缩短术后住院时间，在原发性肝癌手术治疗中有较大的应用价值。Objective To investigate the value of radiofrequency device in liver resection for the treatment of primary liver cancer. Methods The clinical data of 82 patients with primary liver cancer who received liver resection at the First Affiliated Hospital of Xi＇an Jiaotong University from January 2010 to February 2012 were retrospectively analyzed. All patients were divided into radiofrequency liver resection group （41 patients） and routine liver resection group （41 patients）. The clinical characteristics including Child classifi- cation, operation time, intraoperative blood loss, and postoperative complications of the 2 groups were compared. All data were analyzed using the t test or ehi-square test. Results The mean operation time of the radiofrequency liver resection group was （77 ± 28）minutes, which was significantly shorter than （129 _± 34）minutes （t = 7.432, P 〈 0.05 ）. The number of patients who received inflow occlusion in the radiofrequency liver resection group was 4, which was significantly smaller than 23 in the routine liver resection group （ X^2 = 19. 934, P 〈 0.05 ）. The volumes of operative blood loss and rate of patients who received blood transfusion were （241±214）ml and 15% （6/41） in the radiofrequeney liver resection group, （751± 421 ）ml and 49% （20/41） in the routine liver resection group （t = 6. 920, X^2 = 11. 038, P 〈 0.05 ）. There were no significant difference in the rate of postoperative blood loss and biliary leakage between the 2 groups （ X^2 = 0. 213, 1. 822, P 〉 0.05）. The mean postoperative hospital stay of the radiofrequency liver resection group was （9 ± 4 ） days, which was significantly shorter than （ 12± 7） days of the routine liver resection group （ t = 2. 368, P 〈 0.05 ）. No patients died intraoperatively. Conclusion The radiofrequeney device could effectively control blood loss, shortens operation time and postoperatively hosptial stay, and it has great value in the liver resection for the treatment of p

关 键 词：肝肿瘤 肝切除 射频凝血器 

分 类 号：R657.3[医药卫生—外科学]