CAJ | 학술논문

目的评价射频凝固器(Habib 4X)在肝切除术中的应用价值.方法回顾性分析2009年11月至2010年4月天津市第三中心医院应用Habib 4X对21例肝胆疾病患者施行肝切除术的临床效果.结果成功完成21例肝切除术,其中右半肝切除3例,左半肝切除1例,2个肝段以上切除9例,单一肝段切除7例,肝脏局部切除1例.肿瘤均完整切除.平均切除时间(50±25)min,平均出血量(129±117)ml.术后无患者进入ICU.术后患者发生胆汁漏3例,淋巴液漏1例,胸腔积液4例,均经非手术治疗痊愈.全组患者无术后腹腔内出血、肝功能衰竭、伤口感染和围手术期死亡.术后平均住院时间(19±14)d.结论肝切除术中应用Habib 4X辅助切肝,其射频能量可使拟切除面肝组织脱水凝固,闭合局部血管及其他管道系统,不阻断入肝血流,无需预先处理将要离断的粗大血管,可明显减少切除过程中的出血甚至不出血,降低术后并发症的发生率,使肝切除过程更安全、快捷.
목적 평개사빈응고기(Habib 4X)재간절제술중적응용개치.방법 회고성분석2009년11월지2010년4월천진시제삼중심의원응용Habib 4X대21례간담질병환자시행간절제술적림상효과.결과 성공완성21례간절제술,기중우반간절제3례,좌반간절제1례,2개간단이상절제9례,단일간단절제7례,간장국부절제1례.종류균완정절제.평균절제시간(50±25)min,평균출혈량(129±117)ml.술후무환자진입ICU.술후환자발생담즙루3례,림파액루1례,흉강적액4례,균경비수술치료전유.전조환자무술후복강내출혈、간공능쇠갈、상구감염화위수술기사망.술후평균주원시간(19±14)d.결론 간절제술중응용Habib 4X보조절간,기사빈능량가사의절제면간조직탈수응고,폐합국부혈관급기타관도계통,불조단입간혈류,무수예선처리장요리단적조대혈관,가명현감소절제과정중적출혈심지불출혈,강저술후병발증적발생솔,사간절제과정경안전、쾌첩.
Objective To investigate the value of Habib 4X in hepatic resection. Methods The clinical outcome of 21 patients with liver disease who received liver resection at the Tianjin Third Central Hospital from November 2009 to April 2010 were retrospectively evaluated. All the operations were carried out by using Habib 4X. Results All patients received hepatectomy, including right hepatectomy in three patients, left hepatectomy in one patient, multiple segmentectomy in nine patients, single segmentectomy in seven patients and partial liver resection in one patient. All tumors were reseeted completely. The mean operation time was (50±25) minutes and the mean blood loss was(129±117)ml. No patient was transferred to ICU. Three patients were complicated with bile leakage, one with lymphatic leakage and four with pleural effusion, and they were cured by non-surgical treatment. There were no patients with postoperative hemorrhage, incision infection or hepatic failure. No mortality was observed. The mean postoperative hospital stay was(19±14)days. Conclusions Radiofrequency energy was applied along the margins of the tumor to create zones of necrosis before resection with a scalpel, offering hepatobiliary surgeons an additional method for performing liver resections with minimal blood loss, low morbidity and mortality rates. As for malignant tumors, minor or major liver resection assisted by Habib 4X is safe, and it can reduce the chance of positive incisal margin.