临床合理用药杂志
臨床閤理用藥雜誌
림상합리용약잡지
Chinese Journal of Clinical Rational Drug Use
2015年
27期
114-115
,共2页
肝肿瘤%腹腔镜检查%肝切除术%治疗结果
肝腫瘤%腹腔鏡檢查%肝切除術%治療結果
간종류%복강경검사%간절제술%치료결과
Liver neoplasms%Laparoscopy%Hepatectomy%Treatment outcome
目的：探讨腹腔镜左肝外叶切除术操作要点及解剖基础。方法选取2014年4—12月于景德镇市第一人民医院行腹腔镜左肝外叶切除术的肝脏疾病患者10例，术后查阅文献并结合手术经验总结腹腔镜肝左外叶切除术的操作要点与解剖注意事项。结果患者左肝外叶静脉均为Ⅲ段属支，其中单支型7例，双支型3例；属支距切断面前缘0.6~1.7cm，平均（1.2±0.3）cm；属支距膈面0.5~1.7cm，平均（1.2±0.2）cm；均顺利完成手术；手术时间166~254min，平均（195.5±13.8）min；术中出血量105~208ml，平均（108.2±20.2）ml；术后拔除腹腔引流管时间2~6d，平均（3.3±0.5）d；住院时间5~15d，平均（8.5±2.2）d；患者术后均未发生严重并发症。结论充分掌握手术操作要点并明确左肝外叶解剖方法后，腹腔镜左肝外叶切除术可推广至各阶层医院应用。
目的：探討腹腔鏡左肝外葉切除術操作要點及解剖基礎。方法選取2014年4—12月于景德鎮市第一人民醫院行腹腔鏡左肝外葉切除術的肝髒疾病患者10例，術後查閱文獻併結閤手術經驗總結腹腔鏡肝左外葉切除術的操作要點與解剖註意事項。結果患者左肝外葉靜脈均為Ⅲ段屬支，其中單支型7例，雙支型3例；屬支距切斷麵前緣0.6~1.7cm，平均（1.2±0.3）cm；屬支距膈麵0.5~1.7cm，平均（1.2±0.2）cm；均順利完成手術；手術時間166~254min，平均（195.5±13.8）min；術中齣血量105~208ml，平均（108.2±20.2）ml；術後拔除腹腔引流管時間2~6d，平均（3.3±0.5）d；住院時間5~15d，平均（8.5±2.2）d；患者術後均未髮生嚴重併髮癥。結論充分掌握手術操作要點併明確左肝外葉解剖方法後，腹腔鏡左肝外葉切除術可推廣至各階層醫院應用。
목적：탐토복강경좌간외협절제술조작요점급해부기출。방법선취2014년4—12월우경덕진시제일인민의원행복강경좌간외협절제술적간장질병환자10례，술후사열문헌병결합수술경험총결복강경간좌외협절제술적조작요점여해부주의사항。결과환자좌간외협정맥균위Ⅲ단속지，기중단지형7례，쌍지형3례；속지거절단면전연0.6~1.7cm，평균（1.2±0.3）cm；속지거격면0.5~1.7cm，평균（1.2±0.2）cm；균순리완성수술；수술시간166~254min，평균（195.5±13.8）min；술중출혈량105~208ml，평균（108.2±20.2）ml；술후발제복강인류관시간2~6d，평균（3.3±0.5）d；주원시간5~15d，평균（8.5±2.2）d；환자술후균미발생엄중병발증。결론충분장악수술조작요점병명학좌간외협해부방법후，복강경좌간외협절제술가추엄지각계층의원응용。
Objective To explore the operating points and anatomical basis of laparoscopic hepatic left lateral lobecto-my. Methods A total of 10 hepatic disease patients treated with laparoscopic hepatic left lateral lobectomy were selected in the First People's Hospital of Jingdezhen from April to December 2014,operating points and the anatomical considerations of laparo-scopic hepatic left lateral lobectomy were summarized by literature review and operative experience. Results Patients with left extrahepatic leaf veins were Ⅲ section genus branch,single branch type was 7 cases,double branch types was 3 cases;genus branch distance to cutting faces leading edge was 0. 6 ~ 1. 7cm,average at(1. 2 ± 0. 3)cm;genus branch distance to dia-phragmatic surface was 0. 5 ~ 1. 7cm,average at(1. 2 ± 0. 2) cm;operation were completed smoothly;operation time were 166 ~ 254min,average at(195. 5 ± 13. 8)min;intraoperative blood loss were 105 ~ 208ml,average at(108. 2 ± 20. 2)ml;postoperative peritoneal cavity drainage tube pull out of time were 2 ~ 6d,average at(3. 3 ± 0. 5)d;hospitalization time were 5 ~ 15d,average at(8. 5 ± 2. 2)d;no one occurred postoperative serious complications. Conclusion Fully grasp the operat-ing points and clear anatomical methods of hepatic left lateral,laparoscopic hepatic left lateral lobectomy application can be ex-tended to all levels of hospital.
