腹腔引流术在肝脏切除术后应用的必要性探讨

The study on the application of abdominal drainage after liver resection

目的探讨腹腔引流术在肝脏切除术后应用的必要性。方法将我院肝脏外科自2008年1月至2009年6月问连续实施的210例肝脏切除术的患者按时间先后分成腹腔引流组（120例）和非引流组（90例）。分析比较患者术前因素，术中因素以及术后并发症和住院时间。结果两组患者术前和术中各项指标较为相近，差异无统计学意义（P〉0．05），术后并发症具备可比性。术后引流组和非引流组死亡率分别为0．8％和1．1％，差异无统计学意义（χ2=0．042，P〉0．05）。引流组外科并发症明显高于非引流组，尤其是腹部感染和腹水渗出较非引流组高，差异有统计学意义（P〈0．05）。两组患者术后内科学并发症没有明显的差异（χ2=0．338，P〉0．05）。引流组住院时间（13．1±5．2）d较非引流组（11．4±5．6）d长，但差异无统计学意义。结论本组结果表明肝脏切除术后腹腔引流术的应用没有必要性，甚至会增加术后并发症。

Objective Tovinvestigate the application of abdominal drainage after liver resection. Methods From Jan 2008 to June 2009, 210 consecutively admitted patients undergoing liver resection by the same surgical team were chronologically allocated into drainage group （120） and non-drainage group （90）. Patient ＂s preoperative characteristics, operation-related factors, postoperative complications and hospital stay were compared between the two groups. Results Postoperative complications were comparable between the two groups, which was not significantly different among preoperative characteristics and operation-related factors （P 〉 0. 05 ）. Mortality was 0.8% in drainage group and 1.1% in non-drainage group, again, the difference was not significant （χ2 = 0. 042, P 〉 0. 05 ）. Surgical complications were significantly higher in drainage group than in non-drainage group, especially for abdominal infection and aseites occurrence （ P 〈 0. 05 ）. The hospital stay was significantly longer in the drainage group （ 13.1 ± 5. 2） days than the non-drainage group （ 11. 4 ± 5. 6 ） days. Conclusions Postoperative abdominal drainage is not necessary for patients undergoing liver resection, furthermore, abdominal drainage increases postoperative complications.