CAJ | 학술논문

目的探讨术中超声(IOUS)在射频辅助肝切除术中的临床应用价值.方法 IOUS引导下应用射频辅助肝切除技术对32例患者实施肝切除,分析总结IOUS在肝切除前、切除术中及切除后的作用.结果32例患者在IOUS引导下成功完成肝切除手术,全部病灶均被完整切除,术中未出现拟保留血管、胆管的误损伤.平均肝切除时间(53.6±28.4) min,肝实质离断过程平均失血量(115.3±118.5) ml,术中及术后无一例输血.术后发生胆漏3例,淋巴漏1例,胸腔积液6例,均经积极非手术治疗痊愈.无术后腹腔内出血、肝功能衰竭及伤口感染等.术后平均住院(20.5±16.8)d.结论 IOUS能精确地引导射频辅助肝切除术安全、顺利地进行,确保病灶被完整切除的同时最大限度地保留肝组织,并且避免拟保留脉管结构的误损伤,具有重要的临床价值.
목적 탐토술중초성(IOUS)재사빈보조간절제술중적림상응용개치.방법 IOUS인도하응용사빈보조간절제기술대32례환자실시간절제,분석총결IOUS재간절제전、절제술중급절제후적작용.결과32례환자재IOUS인도하성공완성간절제수술,전부병조균피완정절제,술중미출현의보류혈관、담관적오손상.평균간절제시간(53.6±28.4) min,간실질리단과정평균실혈량(115.3±118.5) ml,술중급술후무일례수혈.술후발생담루3례,림파루1례,흉강적액6례,균경적겁비수술치료전유.무술후복강내출혈、간공능쇠갈급상구감염등.술후평균주원(20.5±16.8)d.결론 IOUS능정학지인도사빈보조간절제술안전、순리지진행,학보병조피완정절제적동시최대한도지보류간조직,병차피면의보류맥관결구적오손상,구유중요적림상개치.
Objective To explore the clinical value of intraoperative ultrasound (IOUS) in liver resection with radiofrequency-assisted technique.Methods Thirty-two patients underwent hepatic resection with radiofrequency-assisted technique by IOUS-guidance.The use of IOUS before,during and after resection were analyzed.Results All patients were completed hepatic resection by IOUS-guidance successfully.All lesions were resected drastically,and the reserved blood vessel and biliary duct were not injured.The mean transaction time was (53.6 ± 28.4) minutes and the mean blood loss during resection was (115.3 ± 118.5)ml.No patient needed blood transfusion.Nine patients developed postoperative complications including 3 bile leaks,1 lymph leak and 6 pleural effusions.There were no cases of postoperative haemorrhage,liver failure or wound infection.The mean postoperative stay was (20.5 ± 16.8) days.Conclusions The hepatectomy with radiofrequency-assisted technique can be guided by IOUS accurately.As IOUS-guidance,the lesions are resected drastically and liver tissue is reserved farthest,and the injury of blood vessel and biliary duct is avoided.IOUS is significant value in liver resection with radiofrequency-assisted technique.