LigaSure与钳夹法在单发肝癌切除术中的比较  

Comparison of Liga Sure and Clamp Crushing Method in Hepatectomy for Single Hepatocellular Carcinoma

作　　者：秦红波[1] 石洁[2] 郭卫星[2] 李楠[2] 周飞国[2] 程树群[2] 

机构地区：[1]浙江省嘉兴市第二医院肝胆外科 [2]第二军医大学东方肝胆外科医院肝外六科,上海200438

出　　处：《中国微创外科杂志》2015年第9期786-788,共3页Chinese Journal of Minimally Invasive Surgery

基　　金：上海市科委青年启明星人才项目2014-2016(项目编号:14QA1405000)

摘　　要：目的比较Liga Sure与钳夹法在单发肝癌切除术中的应用价值。方法 2014年6-11月,回顾性分析我科60例单发肝癌患者资料,30例应用Liga Sure,30例应用钳夹法,比较2组手术时间、断肝时间、肝断面处理时间、术中出血量,术前和术后第1、3、5天血清丙氨酸氨基转移酶（ALT）、总胆红素（TBIL）的变化,术后并发症发生情况。结果与钳夹组相比,Liga Sure组手术时间长[（130.7±27.0）min vs.（115.2±27.8）min,t=2.106,P=0.044],断肝时间长[（25.6±12.1）min vs.（15.1±7.2）min,t=3.703,P=0.001],但肝断面处理时间短[（11.9±2.7）min vs.（16.4±7.3）min,t=-2.281,P=0.007],术中失血量少[（145.0±130.2）ml vs.（233.3±164.7）ml,t=-2.150,P=0.040],差异均有统计学意义。2组术前和术后第1、3、5天ALT和TBIL及术后并发症发生率差异无统计学意义。结论与钳夹法比较,Liga Sure行肝癌切除术虽断肝时间长,但肝断面处理时间短,术中出血量少,更具有优势。Objective To evaluate the use of liga Sure and clamp crushing method during hepatectomy for single hepatocellular carcinoma. Methods From June 2014 to November 2014,Liga Sure was used during hepatectomy in 30 patients（ L group） and clamp crushing method was used in 30 patients（ C group）. The clinical data of the L group and C group were analyzed retrospectively. Total operation time, liver transection time, treatment time of liver wound surface, intraoperative blood loss,perioperative and 1,3,5-day postoperative serum alanine aminotransferase（ ALT）,total bilirubin（ TBIL）,and postoperative complications were observed. Results The total operation time in the L group was longer than that in the C group [（ 130. 7 ± 27. 0）min vs.（ 115. 2 ± 27. 8） min,t = 2. 106,P = 0. 044]. The liver transection time in the L group was longer than that in the C group[（ 25. 6 ± 12. 1） min vs.（ 15. 1 ± 7. 2） min,t = 3. 703,P = 0. 001]. The treatment time of liver wound surface in the L group was shorter than that in the C group [（ 11. 9 ± 2. 7） min vs.（ 16. 4 ± 7. 3） min,t =- 2. 281,P = 0. 007]. The intraoperative blood loss in the L group was less than that in the C group [（ 145. 0 ± 130. 2） ml vs.（ 233. 3 ± 164. 7） ml,t =- 2. 150,P = 0. 040]. The perioperative and 1,3,5-day postoperative serum ALT,TBIL,postoperative complications were similar between the two groups.Conclusion Use of Liga Sure has longer liver transection time,which is associated with significant decreased intraoperative blood loss and treatment time of liver wound surface as compared with clamp crushing method.

关 键 词：肝癌 肝切除术 LIGA Sure 钳夹法 

分 类 号：R735.7[医药卫生—肿瘤]