射频凝血器辅助腹腔镜下肝切除的临床应用

目的探讨射频凝血器辅助腹腔镜下肝切除的临床应用价值。方法随机将2013年3月~2015年12月我院收治的100例行腹腔镜下肝切除术患者分为研究组和对照组各50例,研究组实施射频凝血器辅助治疗,对照组另实施常规钳夹辅助治疗,观察2组一般指标(手术时间、术中出血量、住院时间)、手术效果(输血患者比例、术后24h腹腔引流量)、肝功能(以谷丙转氨酶(ALT)、总胆红素(TBi L)、谷草转氨酶(AST)评估)、术后并发症发生率及术后1年随访生存率。结果与对照组相较,研究组手术时间、住院时间均显著短,术中出血量显著少,输血患者比例、24h腹腔引流量、胆漏感染并发症总发生率显著低,术后1年随访生存率显著高,均有统计学意义(P0.05);术前2组肝功能指标相较无明显差异(P0.05);术后2组肝功能指标较术前显著降低,且研究组的改善幅度较对照组明显,有统计学意义(P0.05)。结论射频凝血器辅助腹腔镜下肝切除可明显缩短患者手术及住院时间、降低术中出血量、提高手术效果及1年生存率、改善肝功能、降低术后并发症风险,值得推广应用。

Clinical application of radiofrequency coagulator assisted laparoscopic hepatectomy

Objective To investigate the clinical application value of radiofrequency coagulator assisted laparoscopic hepatectomy.Methods From March 2013 to December 2015,100 cases undergoing laparoscopic hepatectomy in our hospital were randomly divided into the study group and the control group,50 cases in each group.The study group received radiofrequency coagulator assisted therapy,while the control group received routine forceps clip assisted therapy.The general indexes,operation effects,liver function,incidence of postoperative complications and 1-year survival rate were observed.Results Compared with the control group,the operation time and length of hospital stay of the study group were significantly shorter,the intraoperative blood loss was less,the proportion of patients with blood transfusion,24h peritoneal drainage volume and the incidence of bile leakage and infection were significantly lower,and the 1-year survival rate was significantly higher (P ＜ 0.05).There was no significant difference in liver function indexes between the two groups before operation (P ＞ 0.05).Mter operation,the liver function indexes were significantly lower than those before operation,and the improvement in study group was more significant than that in the control group (P ＜ 0.05).Conclusion Radiofrequency coagulator assisted laparoscopic hepatectomy can significantly shorten the operation time and length of stay of patients,reduce the intraoperative blood loss,improve the operation effects,1-year survival rate and liver function,and reduce the risk of postoperative complications.