双极电凝钳在脾切除及贲门周围血管离断术中应用的随机对照试验  

BiClamp forceps in splenectomy and pericardical devascularization： a randomized controlled trial

作　　者：贾哲[1] 张珂[1] 黄容海[1] 丁振昊[1] 鲁岩[1] 赫嵘[1] 李宝亮[1] 李勤涛[1] 郭立民[1] 蒋力[1] 

机构地区：[1]首都医科大学附属北京地坛医院肝胆外科,北京100015

出　　处：《中华肝胆外科杂志》2014年第9期644-647,共4页Chinese Journal of Hepatobiliary Surgery

基　　金：北京市科委首都临床特色应用研究资助（Z121107001012169）

摘　　要：目的 比较传统钳夹法与双极电凝钳两种方式在脾切除及贲门周围血管离断术中的效果.方法 采用单盲随机对照试验设计,将60例拟行脾切断流手术的患者随机分为双极电凝钳组（n=30）和传统钳夹组（n=30）.以手术时间为主要评价指标,以术中出血量、术后并发症发生率、出院时间为次要评价指标,对两组患者围手术期情况进行比较.结果 两组患者术前基本情况配对良好.分析显示双极电凝组手术时间显著低于传统钳夹组[（4.21±0.57）h比（5.21±0.54）h; P＜0.05].双极电凝钳组术后出血倾向、切口感染发生率降低,住院时间显著缩短（P＜0.05）.结论 在脾切除及贲门周围血管离断术中,双极电凝钳的使用可明显减少术中出血,缩短手术时间,降低术后出血倾向及切口感染发生率、缩短住院时间.并且双极电凝钳在手术操作中更为简便并节省成本.Objective A randomized controlled trial to compare BiClamp forceps with conventional suture ligation in splenectomy and pericardial devascularization.Methods A single-blind randomized controlled trial （RCT） was conducted on 60 patients with hypersplenism and esophageal varices who underwent splenectomy and pericardial devascularization using either BiClamp forceps （n =30） or conventional suture ligation （n =30）.We compared the operation time,intraoperative blood loss,incisional wound infection rate and hospital stay between the two groups.Results The preoperative demographic data of the two groups were well matched.The operating time was significantly shorter in the BiClamp than in the control group [（4.21 ± 0.57） h vs （5.21 ± 0.54） h; P 〈 0.05].Intraoperative blood loss,incisional wound infection rate and hospital stay were significantly lower in the BiClamp group （P 〈 0.05）.The other adverse event rates did not differ significantly.Conclusion BiClamp forceps proved to be superior or similar to conventional ligation,particularly in operating time,intraoperative blood loss,postoperative blood loss and incision infection rate,hospitalization stay.Moreover,BiClamp forceps was easier to use and it was more cost effective.

关 键 词：双极电凝钳 脾切除术 血管离断术 门静脉高压症 

分 类 号：R657.6[医药卫生—外科学]