护固莱士和泰绫应用于精准肝切除创面的对比研究

目的：比较护固莱士和泰绫应用于肝创面止血的临床疗效。方法选取2013年9月－2014年10月某院因肝脏良、恶性肿瘤行精准肝切除术60例，随机分为护固莱士组、泰绫组、对照组。观察术后腹腔引流液、引流液血红蛋白浓度、胆红素浓度及肝功能等指标。结果三组年龄、性别、Child评分、病理类型、肿瘤大小、手术时间、出血量、手术创面面积等差异无统计学意义（P＞0．05）。术后三组患者肝功能恢复无明显差异（P＞0．05）。使用护固莱士和泰绫处理手术创面组，患者术后72 h的引流量及引流液中血红蛋白浓度均较对照组明显减少（ P＜0．05）；患者术后第1天腹腔引流液中血红蛋白浓度护固莱士组比泰绫组低（P＜0．05）；护固莱士组患者术后前3 d腹腔引流液中胆红素浓度比泰绫组、对照组低（P＜0．05）。结论精准肝切除术肝创面的处理直接影响到患者术后恢复，泰绫能减少术后腹腔引流液量及出血量，而护固莱士不仅可减少术后腹腔引流量及出血量，还可以减少胆汁漏量。

Comparison of home-made absorbable hemostatic agents on cutting surface of hepatectomy

Objective To compare the hemostatic effect of fibringlue and tistat on hepatic cutting surface on human. Methods 60 patients with benign or malignant liver tumors who received precision liver resection surgery in 81 Hospital from Septem?ber 2013 to October 2014 were enrolled in this study. According to the management of the hepatic cutting surface, the 60 patients were averagely divided into three groups:the fibringlue group, the tistat group and the control group. The drainage volume, hemoglobin and bilirubin in abdominal drainage, liver function after operation were determined and compared among the three groups. Results There were no significant differences among the three groups in age, gender, Child Pugh score, pathological type, tumor size, operative time, hemorrhage volume, wound area and postoperative recovery of liver function( P>0.05) . The drainage volume and the hemoglobin in abdominal drainage of 72 hours after operation was significantly less in the fibringlue group and the tistat group than in the control group ( P<0.05) . Hemoglobin in the abdominal drainage fluid on postoperative day 1 were significantly lower in the fibringlue group than in the tistat group. Bilirubin of the abdominal drainage fluid in 72 hours after operation were significantly lower in the fibringlue group than in thetistat group and the control group ( P<0.05) . Conclusion The management of hepatic cutting surface will directly affect the patients’ postoperative recovery. Tistant can significantly reduce postoperative abdominal drainage volume and hemorrhage. Fibringlue can not only significantly reduce postoperative abdominal drainage volume and hemorrhage, but also the incidence of biliary leakage.