射频止血技术在肝切除术中的应用

目的 探讨射频止血技术在肝切除术中的临床应用价值.方法 回顾性总结2009年1月至2011年2月实施肝脏肿瘤切除患者60例.术中应用射频止血技术(raido-frequencyhemostasis,RFH)30例为射频组,传统钳夹法(clamp crushing method,CCM)30例作为对照组,两组患者年龄,性别,术前肝功能指标,病变大小等方面差异无统计学意义(P＞0.05).记录患者手术时间、术中出血量、术后肝功能恢复情况,术后3d引流量,术后第1、7天ALT及T-BIL水平等方面进行对比研究.结果 RFH组术中出血(219±62) ml明显少于CCM组(416 ±96) ml,差异有统计学意义(t =5.241,P＜0.05),RFH组未发生大出血,CCM组5例术中损伤肝静脉,3例出现大出血.术后3d引流量RFH组明显少于CCM组,术后第1、7天ALT及T-BIL比较,RFH组明显小于CCM组(分别t =5.987,16.803,22.264,8.386,8.255,均P＜0.05).术后肝功能恢复RFH组明显快于CCM组.结论 射频止血技术在肝切除术中具备损伤小,出血量少,恢复快、安全性高等优势.

Radio-frequency hemostasis in hepatectomy

Objective To evaluate radio-frequency hemostasis in hepatectomy.Methods From January 2009 to February 2011,the clinical data of 60 patients undergoing curative liver resection were divided into two groups using radio-frequency hemostasis (RFH) and clamp crushing method (CCM) respectively,RFH group (30 cases) and CCM group (30 cases).There was no difference between the 2 groups regarding the age,sex.hepatic function and tumor size.Data regarding the intra-operative and postoperative courses of the patients were analyzed.Results No damage of hepatic vein occured in RFH group.Hepatic veins rupture occurred in 5 cases and massive bleeding occurred in 3 cases in CCM group.lntra-operative blood loss was significantly less in FRH group [ (219 ±62) ml] than in CCM group [ (416 ±96) ml ] (P ＜ 0.05 ).The postoperative drainage volume in RFH group was significantly less than that in CCM group on the third postoperative day.The serum ALT and T-BIL in RFH group was significantly lower than that in CCM group on postoperative day 1 and day 7 ( separately t =5.987,16.803,22.264,8.386,8.255,all P ＜0.05 ).Postoperative hepatic function in RFH group was significantly better than that in CCM group.Conclusions The use of radio-frequency hemostasis in hepatectomy is less traumatic,of less bleeding,faster recovery than clamp crashing method.