血管闭合系统在贲门周围血管离断术中的应用价值

目的探讨LigaSureTM血管闭合系统(LigaSureTMvesselsealingsystem,LVSS)在贲门周围血管离断术中的应用价值。方法对34例肝硬化门静脉高压症合并食管胃底静脉曲张破裂出血患者分别采用单纯贲门周围血管断离术(单纯断流组,18例)和LVSS(LVSS组,16例)的临床资料进行回顾性对比分析。结果单纯断流组术中失血量平均220ml,手术时间平均129min;LVSS组术中失血量平均120ml,手术时间平均98min;两组比较差异有显著性意义,P均<0.01。单纯断流组术后有13例患者出现并发症(膈下感染、反应性胸腔积液、肝功能衰竭、术后近期再出血),1例死亡;LVSS组仅2例出现反应性胸腔积液。结论LVSS止血确切,操作方便,可有效减少术中失血,缩短手术时间,具有一定的临床应用价值。

Clinical value of LigaSureTM vessel sealing system (LVSS) in pericardial devascularization

Objective To investigate the clinical value of LigaSureTM vessel sealing system(LVSS)in pericardial devascularization. Methods Thirty four cases of gastroesophageal varices bleeding with cirrhotic portal hypertension which underwent simple devascularization or LVSS were reviewed retrospectively. Results The volume of blood loss was 220 ml in simple devascularization group,significantly higher than 120 ml in LVSS group(P< 0.01). The operating time was 129 min in simple devascularization group,significantly longer than 98 min in LVSS group(P< 0.01). Thirteen cases in simple devascularization group had complications including subphrenic infections,reactive pleural effussion,hepatic failure and recurrent variceal bleeding in a short term postoperatively,while only 2 cases had reactive pleural effusion in LVSS group. Conclusion LVSS has more advantages such as stopping hemorrhage definitely,facility of operation,and shortening operative time,less damage to the liver function,which is a rational and practical procedure for clinical application.