微波凝固辅助治疗严重肝外伤临床研究  

Clinical study of microwave coagulation auxiliary treatment for severe liver trauma

作　　者：周亚东[1] 熊祖明[1] 许仲平[1] 

机构地区：[1]重庆市涪陵中心医院肝胆外科,重庆408000

出　　处：《肝胆胰外科杂志》2015年第5期369-372,共4页Journal of Hepatopancreatobiliary Surgery

摘　　要：目的探讨微波凝固治疗III^V型肝外伤伴活动性出血的应用价值。方法回顾性分析2010年9月至2014年9月间我院收治的55例严重肝外伤手术病例资料,按AAST分级III级23例,IV级26例,V级6例;合并其他器官损伤45例。行微波凝固治疗29例,常规确定性手术26例,对比分析微波凝固治疗手术与常规确定性手术在手术时间、住院时间、术中出血量、并发症发生率、治愈率等指标的差异。结果微波组手术时间(120±25)min,常规手术组手术时间(186±45)min,两组差异有统计学意义(P=0.03);微波组住院时间低于常规手术组,分别为(11.4±3.5)d和(17.3±8.9)d,差异有统计学意义(P=0.04);微波组术中出血量明显低于常规手术组,分别为(210±40)m L和(500±75)m L,差异有统计学意义(P=0.01);两组并发症发生率、肝功及治愈率差异无统计学意义(P>0.05)。结论微波凝固辅助下对III^V型肝外伤伴活动性出血疗效明确,可明显缩短手术时间及住院时间,减少术中出血量,改善预后。Objective To explore the application value of microwave coagulation in type III-V liver trauma with active bleeding. Methods Fifty-five cases of severe liver trauma surgery between Sep. 2010 to Sep. 2014 in our hospital were retrospectively analyzed. According to AAST classification, III level 23 cases, IV level 26 cases, V level 6 cases. Other organ damages were found in 45 cases. Patients were divided into microwave coagulation treatment group （29 cases） and conventional deterministic operation group （26 cases）, the operation duration, hospitalization duration, intraoperative blood loss, complications, cure rate between two groups were analyzed. Results The operation duration [（120±25） min vs （186±45） mini, hospitalization duration [（11.4±3.5） d vs （17.3± 8.9） d], and the intraoperative blood loss [（210±40） mL vs （500±75） mL] in microwave group were significant different from conventional groups （P〈0.05）. There was no significant difference in complications rate, liver function and cure rate between two groups （P〉0.05）. Conclusion Microwave coagulation auxiliary has good effect on type III - V liver trauma with active bleeding, which can obviously shorten operation and hospitalization duration, and reduce the intraoperative blood loss, improve the prognosis.

关 键 词：微波凝固治疗 肝外伤 

分 类 号：R657.3[医药卫生—外科学]