后腹腔镜肾上腺手术不同止血方法的效果评价

Dimiution of blood lost underwent the principal adrenal laparoscopic surgery

目的评价生物蛋白胶(FibrinSealant)及止血纱布(速即纱)在后腹腔镜肾上腺手术中的止血效果。方法采用生物蛋白胶注入术区的方法完成后腹腔镜肾上腺全切及部分切除(含腺瘤切除)手术47例,采用速即纱填塞术区的方法完成腹腔镜肾上腺手术25例,未使用止血材料22例为对照组,分别观察肾上腺切除和肾上腺部分切除术后引流量、引流时间、住院时间及术后并发症发生率,并与对照组比较。结果速即纱组在肾上腺全切及部分切除术后的引流量、引流时间、住院天数及并发症发生率均明显低于对照组,而生物蛋白胶组肾上腺全切术后只有住院时间明显低于对照组,肾上腺部分切除术后引流量及引流时间均明显低于对照组。结论止血纱布(速即纱)应用于后腹腔镜肾上腺手术具有显著减少术中出血及术后继发出血、减少术后创面渗出、缩短住院时间、减轻术后痛苦及促进患者病情恢复等优点,生物蛋白胶在肾上腺部分切除术中是可选择的止血方法。

[Objective] To evaluate the efficacy of fibrin sealant and surgical in the principal adrenal laparoseopic surgery. [Methods] Sealing of the adrenal bed with fibrin sealant in 47 cases and surgical in 25 cases, neither in other 22 cases. The amount of the effusion, the time of pulling pipe, the time of being in hospital and the rate of postoperation complication were detected. [Results] All the data of surgicel were less than control group. The time of being in hospital post adrenalectomy and the amount of the effusion. The time of pulling pipe post partical adrenalectomy were less than control. [Conclusion] For the using of surgicel and fibrin sealant, the time of being in hospital, the pain postoperation and losting blood were reduced apparendy.