前入路腹腔镜右半肝切除术血管切割闭合器两枪法的临床效果研究  

Clinical effect of anterior approach laparoscopic right hemihepatectomy with two gun vascularizer

作　　者：林树俊 钟波 王甫誉 郑永彬 陈斯聪 黄诗栋 程新生 缪丁丁 高金亭 Lin Shujun;Zhong Bo;Wang Fuyu;Zheng Yongbin;Chen Sicong;Huang Shidong;Cheng Xinsheng;Miao Dingding;Gao Jinting(Department of Hepatobiliary and Pancreatic Surgery,Huazhong University of Science and Technology Union Shenzhen Hospital,Shenzhen Guangdong Province 518000,China)

机构地区：[1]华中科技大学协和深圳医院肝胆胰外科,深圳518000

出　　处：《中华普外科手术学杂志（电子版）》2022年第6期631-634,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：深圳市南山区科技计划项目(2020136)。

摘　　要：目的:探讨前入路腹腔镜右半肝切除术(LRH)血管切割闭合器两枪法的临床效果。方法:回顾性分析2019年1月至2021年6月62例行前入路LRH患者的临床资料,根据手术方法的不同分为传统组(n=34,采用传统方法行前入路LRH)和两枪组(n=28,采用血管切割闭合器两枪法行前入路LRH)。数据应用软件SPSS 22.0进行分析,围手术期相关指标等计量资料采用(x±s)表示,其中重复测量数据行重复测量方差分析,其余均行独立样本t检验;术后并发症等计数资料行χ^(2)检验。P<0.05为差异有统计学意义。结果:两枪组手术时间、断肝时间、术中出血量、术中输血情况及引流管留置时间显著优于传统组(P<0.05);时间与方法在白蛋白(ALB)、总胆红素(TBIL)、谷草转氨酶(AST)、谷丙转氨酶(ALT)水平上不存在交互作用(P>0.05),时间与方法在ALB、TBIL、AST、ALT水平上主效应显著(P<0.05);两组患者术后并发症情况比较差异无统计学意义(P>0.05)。结论:采用血管切割闭合器两枪法行前入路LRH不仅缩短了手术时间,减少了术中损伤,还有利于患者术后肝功能恢复,且不增加患者术后并发症发生的风险。Objective To investigate the clinical effect of anterior approach laparoscopic right hemihepatectomy(LRH)with two gun technique.Methods The clinical data of 62 patients who underwent anterior LRH approach from January 2019 to June 2021 were retrospectively analyzed.According to the dfferent surgical methods,they were divided into the traditional group(n=34,using the traditional method for anterior LRH)and the two-shot group(n=28,using the vascular cutting and closure device for two-shot LRH).SPSS 22.O software was used to analyze the data.Perioperative indicators and other measurement data were represented by(x±s).Repeated measurement data were analyzed by repeated measurement analysis of variance,and the rest were analyzed by independent sample t test.Postoperative complications and other counting data were analyzed by χ^(2) test.P<0.05 was considered statistically significant.Results The operation time,liver rupture time,intraoperative blood loss,intraoperative blood transfusion and drainage tube indwelling time in the two-gun group were significantly better than those in the traditional group(P<0.05).There was no interaction between time and method on the levels of ALB,TBil,AST and ALT(P>0.05),while the main effect of time and method on the levels of ALB,TBil,AST and ALT was significant(P<0.05).There was no significant difference in postoperative complications between the two groups(P>0.05).ConclusionThe use of vascular cutting and closing device two-gun method in the anterior approach of LRH not only shortens the operation time,reduces the intraoperative injury,but also facilitates the recovery of postoperative liver function,and does not increase the risk of postoperative complications.

关 键 词：肝切除术 腹腔镜 前入路 血管切割闭合器 两枪法 

分 类 号：R657.3[医药卫生—外科学]