新型微波止血分离器在40例肝切除中的应用  

Application of novel microwave hemostatic device in hepatectomy:experience in 40 patients

作　　者：肖震宇[1] 童兵[1] 杨藩[1] 黄志勇[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院肝脏外科中心,武汉430030

出　　处：《临床外科杂志》2016年第4期266-269,共4页Journal of Clinical Surgery

摘　　要：目的评价新型微波止血分离器在肝切除术中的应用价值。方法使用HeSetor微波止血分离器为40例良恶性肝病患者行肝切除术(HeSetor组),与同时期进行的30例常规手术组进行对比(对照组),对照组采用其他手术器械(超声刀、电刀及双极电凝钳)或钳折法进行断肝处理。结果两组手术均顺利完成。HeSetor组术中肝离断时间平均(53.5±26.2)分钟;术中出血量平均(168.5±102.6)ml;术后肝功能生化指标平均在(6.2±2.5)天恢复,术后并发症发生率为7.5%(3/40例),其中胆漏1例(2.5%),胸腔积液2例(5.0%);术后平均住院时间(8.5±3.5)天。对照组术中肝离断时间平均(60.6±28.3)分钟;术中出血量平均(270.6±175.4)ml;术后肝功能生化指标平均在(8.8±3.1)天恢复;术后并发症发生率为16.6%(5/30例),其中胆漏2例(6.7%),胸腔积液3例(10.0%);术后平均住院时间(10.2±3.3)天。HeSetor组术中出血量、术后肝功能恢复及术后并发症发生率均优于对照组(P<0.05)。结论应用微波止血分离器行肝切除术止血安全可靠,简便易行。Objective To evaluate the application value of the novel＇ microwave hemostatic device in hepatectomy. Methods The clinical data of 40 patients with benign or malignant liver diseases undergoing hepatectomy with microwave hemostatic device（HeSetor） from the February 2010 to the May 2012 were retrospectively analyzed and compared with 30 patients with benign or malignant liver diseases undergoing conventional hepatectomy with conventional surgical technique （ utilization of fundamental surgical instruments and clamp crushing method）. Results All the hepatectomies of both groups were sueeessfully completed. In the group withHeSetor, the average duration time of liver transection was （53.5 ± 26.2 ）min and the average intraoperative blood loss was （ 168.5 ± 102.6 ） ml. The values of liver function back to normal level within（ 6.2 ± 2.5 ） days. The incidence rate of postoperative complications was 7.5% （3/40）. One case suffered from bile leakage （2.5%）, and two cases suffered from hydrothorax（ 5.0% ）. The mean length of postoperative hospital stay was （8.5 ± 3.5 ）days. In the control group, the average duration time of liver transection was （60.6 ± 28.3 ） min and the average intraoperative blood loss was （270.6 ± 175.4） ml. The values of liver function turned back to normal level within（ 8.8 ± 3.1 ） days. The incidence rate of postoperative complications was 16.6% （5/30）. Two cases suffered from bile leakage （6.7%） ,andthree cases suffered from hydrothorax（ 10.0% ）. The mean length of postoperative hospital stay was（ 10.2± 3.3） days. Blood loss of liver transection, blood transfusion in operation, the average duration time of liver function recovery and the incidence rate of postoperative complications were significantly different between the two groups based on univariate analysis （ P 〈 0.05 ）. Conclusion Using microwave hemostatic device in hepatectomyis safe and feasible. This technique can provide the advantages of facility with conveni

关 键 词：肝脏疾病 肝切除术 微波 止血 

分 类 号：R657.3[医药卫生—外科学]