国产超声刀在腹腔镜胆囊切除术中的应用

Clinical application of domestic harmonic scalpel in laparoscopic cholecystectomy

目的探讨国产超声刀在腹腔镜胆囊切除术(laparoscopiccholecystectomy,LC)中的临床应用价值。方法36例在全麻下行改良LC,21例使用国产USI超声刀(USI组),15例使用进口超声刀(GEN组)。结果2组手术均获成功,无中转开腹。术中未发生仪器故障。USI组手术时间(42.6±7.5)min,术后引流量(34.3±14.0)ml,术后住院(4.9±0.9)d,胆囊管凝切速率(335.1±180.3)μm/s,胆囊动脉凝切速率(524.2±127.8)μm/s,胆囊管变性范围(2047.6±376.3)μm;GEN组手术时间(47.0±9.0)min,术后引流量(38.0±3.9)ml,术后住院(4.3±0.9)d,胆囊管凝切速率(403.5±120.1)μm/s,胆囊动脉凝切速率(513.5±125.9)μm/s,胆囊管变性范围(2266.7±306.3)μm。2组上述指标比较差异均无显著性(P>0·05)。结论国产USI超声刀性能指标稳定,各主要指标符合临床要求,手术视野清晰,解剖层次清楚,可以满足脏器、组织的切割和止血。

Objective To explore the clinical value of domestic harmonic scalpel in laparoscopic cholecystectomy. Methods Modified laparoscopic cholecystectomy （LC） was performed in 36 cases under general anesthesia. The operation was completed by using domestic USI harmonic scalpel in 21 cases （ USI Group） and by using imported harmonic scalpel in 15 cases （ GEN Group）. Results The operation was laparoscopically accomplished in both of the groups, without conversions to open surgery. Of the USI Group, the operating time was 42.6 ± 7.5 min, the postoperative drainage was 34.3 ± 14.0 ml, the length of postoperative hospitalization was 4.9 ±0.9 d, the speed for cutting cystic duct was 335. 1± 180.3 μm/s, the speed for cutting cystic artery was 524.2 ± 127. 8 μm/s, and the denaturalization width of cystic duct was 2 047. 6 ＋ 376.3 μm. Of the GEN Group, the operating time was 47.0 ± 9.0 min, the postoperative drainage was 38.0 ± 3.9 ml, the length of postoperative hospitalization was 4.3 ± 0.9 d, the speed for cutting cystic duct was 403. 5 ± 120. 1 μm/s, the speed for cutting cystic artery was 513.5 ± 125.9 μm/s, and the denaturalization width of cystic duct was 2 266.7 ± 306.3 μm. There was no differences in these parameters between the two groups （ P 〈 0.05 ）. Conclusions Use of domestic harmonic scalpel gives stable and precise performance, clear visualization, and high safety.