大功率高频电刀在肝细胞癌肝切除术中的应用

发布时间：2018-07-05 19:14

本文选题：肝肿瘤/外科学 + 癌　；参考：《中国普通外科杂志》2017年01期

【摘要】：目的:探讨高频电刀在肝细胞癌(HCC)肝切除术中的应用价值。方法:将386例HCC患者分为观察组(n=199)和对照组(n=187),观察组采用120 W电凝输出功率电刀进行肝切除术,对照组采用钳夹法加超声刀肝切除。比较两组术中肝门阻断时间、手术时长、术中出血量、术中及术后输红细胞情况及术后引流、肝功能改变、术后并发症、术后住院时间等指标。结果:所有患者均顺利完成手术,观察组术中未出现因大功率高频电流引起的灼伤、心电异常等。与对照组比较,观察组手术时间(192.79 min vs.212.10 min)、肝门阻断时间(5.17 min vs.14.65 min)、术后并发症发生率(21.1%vs.34.2%)、术后红细胞输注率(25.7%vs.36.7%)、术后住院时间(8.87 d vs.12.15 d)均明显减少(均P0.05),但术中出血量(378.56 mL vs.412.75 mL)、术中红细胞输注率(7.5%vs.7.5%)、术后拔管时间(5.83 d vs.6.29 d)无统计学差异(P0.05);观察组术后1、3 d部分肝功能指标优于对照组(均P0.05)。两组术后1、2、3年总生存率差异均无统计学意义(均P0.05)。结论:大功率高频电刀用于HCC肝切除术切肝速度快、止血效果好,使用安全可靠。
[Abstract]:Objective: to evaluate the value of high frequency electric knife in hepatectomy of hepatocellular carcinoma (HCC). Methods: 386 patients with HCC were divided into observation group (n = 199) and control group (n = 187). The time of hepatic hilus occlusion, the duration of operation, the amount of blood lost during operation, the condition of red blood cell transfusion during and after operation, the postoperative drainage, the changes of liver function, postoperative complications and postoperative hospital stay were compared between the two groups. Results: all the patients completed the operation successfully. There were no burns and abnormal ECG in the observation group due to high power and high frequency current. Compared with the control group, The operative time (192.79 min vs.212.10 min), hepatic portal occlusion time) (5.17 min vs.14.65 min),) postoperative complications (21.1vs.34.2%), postoperative erythrocyte infusion rate (25.7vs.36.7%), postoperative hospitalization time (8.87d vs.12.15 d) were significantly decreased (P0.05), but the intraoperative bleeding volume (378.56 mL vs.412.75 mL), intraoperative red blood flow rate (378.56 mL vs.412.75 mL) were significantly decreased (P0.05). The rate of cell infusion (7.5vs.7.5%) and the time of extubation (5.83d vs.6.29 d) had no statistical difference (P0.05). There was no significant difference in the 2-year and 3-year overall survival rates between the two groups (P0.05). Conclusion: high-power high-frequency electric knife is safe and reliable for hepatectomy of HCC.
【作者单位】：广西医科大学附属肿瘤医院肝胆外科/广西肝癌诊疗工程技术研究中心/区域性高发肿瘤早期防治研究广西重点实验室;
【基金】：区域性高发肿瘤早期防治研究广西重点实验室(GKZ201604) 广西壮族自治区卫生和计划生育委员会重点课题基金资助项目(S201513)
【分类号】：R735.7

【参考文献】