TissueLink技术在肝脏手术中增强止血的作用

Hemostasis enhanced by TissueLink technique applied in hepatectomy

目的:采用TissueLink技术进行肝肿瘤切除术,通过提高对肝窦和肝内小血管的凝血和止血功能来提高肝手术的精确性和安全性。方法:采用TissueLink技术进行肝肿瘤切除术40例与传统钳折法进行肝切除术40例对比,观察肝门阻断情况、术中出血量、输血情况、手术时间、住院时间等,对手术的精确性、安全性进行评价。结果:采用TissueLink刀进行肝癌切除组术中仅6例短时间阻断肝门血流,其阻断时间为(8.25±1.78)min,平均失血量(160±80.22)ml,输血8例;而传统钳折法肝癌切除组35例阻断肝门血流,阻断时间为(15.18±3.46)min,平均失血量(500±96.23)ml,输血18例,两组各项对比差异显著(均P<0.05)。Tis-sueLink刀组手术时间要较对照组长,分别为(65±37.77)min和(35±25.33)min,两组对比差异显著,P<0.05。TissueLink刀组住院日19±3.74,对照组20±3.25,两组对比无显著差异,P>0.05。结论:用TissueLink技术进行肝肿瘤切除可以在不阻断肝门或者减少阻断时间的情况下减少术中失血及术中输血,从而减少肝脏功能的损害,提高手术的精确性和安全性。

Objective：To study the accuracy and security of hepatectomy during the operation by using TissueLink technique which increasing the function of blood coagulation and hemostasis. Methods： Compare 40 cases of hepatectomy by TissueLink technique with 40 cases of hepatectomy by classical clamping resection, to evaluate the accuracy and security by observing bleeding volume, controltime of liver blood - supply（Pringles） , cases of blood transfusion, operation time and in hospital time. Results： In TissueLink group, mean bleeding volume was 160m1（40 - 280ml）, Blood infusion were 8 cases, short control of liver blood supply were in 6 patients, control time was 8.25 ± 1.78 （min） . In clamping group, mean bleeding volume was 500 ml（200 - 1400 ml）, Blood infusion were 18 cases, control of liver blood supply were in 35 patients, control time was 15.18 ±3.46. By comparing with each item separately, there were an obvious differences （P 〈 0.05 ） in two groups. Operation time was 65 ± 37.77 （min） in Tis- sueLink group and 35 ±25.33 （min） in clamping group （P 〈 0.05 ）. In hospital time were 19±3.74 days in TissueLink group and 20 ±3.25 days in clamping group no difference（P 〉 0.05 ）. Conclusion： The accuracy and security of hepatectomy were increased because of less bleeding, less blood infusion and less liver disfunction during operation by using TissueLink technique,it need not control the liver blood supply or need shorter control time.