术中超声在射频辅助肝切除术中的应用

The application of intraoperative ultrasound in liver resection with radiofrequency-assisted technique

目的探讨术中超声（IOUS）在射频辅助肝切除术中的临床应用价值。方法IOUS引导下应用射频辅助肝切除技术对32例患者实施肝切除，分析总结IOUS在肝切除前、切除术中及切除后的作用。结果32例患者在IOUS引导下成功完成肝切除手术，全部病灶均被完整切除，术中未出现拟保留血管、胆管的误损伤。平均肝切除时间（53．6±28．4）min，肝实质离断过程平均失血量（115．3±118．5）ml，术中及术后无一例输血。术后发生胆漏3例，淋巴漏1例，胸腔积液6例，均经积极非手术治疗痊愈。无术后腹腔内出血、肝功能衰竭及伤口感染等。术后平均住院（20．5±16．8）d。结论IOUS能精确地引导射频辅助肝切除术安全、顺利地进行，确保病灶被完整切除的同时最大限度地保留肝组织，并且避免拟保留脉管结构的误损伤，具有重要的临床价值。

Objective To explore the clinical value of intraoperative ultrasound （IOUS） in liver resection with radiofrequeney-assisted technique. Methods Thirty two patients underwent hepatic resection with radioffequency-assisted technique by IOUS-guidance. The use of IOUS before, during and after resection were analyzed. Results All patients were completed hepatic resection by IOUS-guidanee successfully. All lesions were resected drastically, and the reserved blood vessel and biliary duct were not injured. The mean transaction time was （53.6 ± 28.4） minutes and the mean blood loss during resection was （115.3 ±118.5） ml. No patient needed blood transfusion. Nine patients developed postoperative complications including 3 bile leaks, 1 lymph leak and 6 pleural effusions. There were no cases of postoperative haemorrhage,liver failure or wound infection. The mean postoperative stay was （20.5 ± 16.8） days. Conclusions The hepatectomy with radiofrequency-assisted technique can be guided by IOUS accurately. As IOUS-guidance, the lesions are resected drastically and liver tissue is reserved farthest, and the injury of blood vessel and hiliary duct is avoided. IOUS is significant value in liver resection with radiofrequency-assisted technique.