超声刀与钳夹法在巨大肝血管瘤手术应用效果的比较  

Comparison of ultrasonic scalpel and clamp crushing in hepatectomy for giant hepatic hemangioma

作　　者：朱迎哲 王继涛 ZHU Ying-zhe;WANG Ji-tao(Department of Surgery,General Hospital of Xingtai Mimng Conglomerate of the Jizhong Energy Group Co.,Ltd.,Xingtai 054000,China;Department of Hepatobiliary Surgery,Xingtai People's Hospital Affiliated to Hebei Medical University,Xingtai 054000,China)

机构地区：[1]冀中能源邢台矿业集团总医院外科,邢台054000 [2]河北医科大学附属邢台市人民医院肝胆外科

出　　处：《肝胆外科杂志》2020年第5期360-363,共4页Journal of Hepatobiliary Surgery

基　　金：河北省重点研发计划项目(182777HD);河北省卫计委科研基金项目(20181612);邢台市科技支撑计划项目(2017ZC106)。

摘　　要：目的比较两种断肝方法(超声刀及钳夹法)对于巨大肝血管瘤患者手术应用效果。方法回顾性分析2013年1月~2018年12月,62例巨大肝血管瘤并接受外科手术的患者,依据术中离断肝组织方法分为:超声刀(US组)及钳夹法(CC组),对两组手术时间、术中出血量,术前与术后第1.5日肝功能指标及术后并发症发生情况进行对比分析。结果62例患者均顺利完成手术,无围手术期死亡病例。UUS组肝切过程出血量较CC组明显减少(P<0.05)。CC组患者术后第1天血,清白蛋白(ALB)水平显著低于US组(P<0.05);CC组患者术后第1天血清总胆红素(TB)、血清丙氦酸转氨酶(ALT)水平均明显高于US组(P<0.05);但两组在术中出血量、手术时间、输入红细胞例数、术后第5天肝功能指标(ALT,TB、ALB)、术后并发症发生率死亡率、术后住院天数等均无统计学差异。结论使用超声刀行巨大肝血管瘤手术与传统钳夹法相比可减少肝切过程中出血,减轻术后肝功能损害,加快肝功能恢复,但两者围手术期及远期治疗效果无明显差异。Objective To compare the elinical therapeutie efets of ultrasonic scalpel and clamp crushing in hepatectomy for the patients with giant hepatic hemangioma.Methods From January 2013 to December 2018,62 patients received hepatectomy were assigned into 2 groups.The two groups were respectively applied ultrasonic scalpel(US group)and clamp erushing(CC group)under-went liver resection.Results Operation was successful in all the 62 patients and no case died during the perioperative.The amount of bleeding in the CC group was significanly increased in liver resection procedure compared with US group(P<0.05).The serum albu-min levels in CC patients were significantly lower than US group on 1-day postoperative(P<0.05);The serum total bilinubin levels in CC patients were significantly higher than US group on l-day postoperative(P<0.05);The serum alanine aminotransferase levels in CC patients were significantly higher than the US group on 1-day postoperative(P<0.05);And there were no staistically signif-cant differences between the two groups in total blood loss,operation time,the number of cases received red blood cells,the liver func-tion(ALT,TB,ALB)in 5 POD,postoperative complications,mortality,postoperative hospital stay respectively.Conclusions Compared to clamp crushing liver resection procedure,ultrasonie scalpel in liver resection can reduce the amount of bleeding,postoper-ative liver damage,so that accelerate recovery of liver function.However,there was no significant difference in the peroperative treat-ment and long-term follow-up between the two groups.

关 键 词：超声刀 钳夹法 肝血管瘤 肝切除 

分 类 号：R735.7[医药卫生—肿瘤]