肝切除术创面不同处理方法效果的临床研究

目的 研究肝切除术肝创面处理方法及其对术后肝功能恢复的影响.方法 回顾性分析我科2009年10月至2010年3月因肝肿瘤行肝切除术53例的临床资料.根据创面处理方法不同分为创面敞开+明胶海绵+医用止血胶止血组(A组,25例),创面敞开+微孔多聚糖止血球(MPH)止血组(B组,19例),创面对缝止血组(C组,9例).对止...

Hemostatic effect of different managements of hepatic cutting surface in hepatectomy

Objective To summarize the management of hepatic cutting surface in heptectomy and its influence on recovery of the liver function after operation. Methods The clinical data of 53 pa- tients with liver neoplasm receiving hepatectomy from October 2009 to March 2010 at our department were reviewed and the patients were divided into three groups according to the management of the he- patic cutting surface. The surface was open and managed with gelatin sponge and medical protein muci- lage in group A, open and cauterized with microporous polysaccharide hemospheres in group B, and sutured in group C. The hemostatsis time-consumption,the blood loss of wound surface at 24, 48, 72 h after the operations and the outcomes of hepatic function test at 1, 3, 5 days after the operations were determined and compared among the three groups. Results The hemostatsis time-consumption in group A was significantly longer than in groups B and C. The blood loss in group B was significant- ly less than in groups A and C at 24, 48, 72 h after the operations. Meanwhile, the change in ALT/TBIL was remarkably higher in group C than in groups A and group B at 1, 3, and 5 days after the operations. In the contrast, the Alb in group C was less than in groups A and I3, and the difference was more significant at the first day after the operations. Conclusion The management of hepatic cut- ting surface can directly affect blood loss and liver function. By using the mieroporous polysaccharide hemospheres we can shorten the hemostatsis time-consumption and decrease the blood loss after the operations, which is beneficial to the recovery of the liver function.