简化腔内Pringle法与传统Pringle法在腹腔镜肝切除术中安全性及有效性前瞻性对比研究

Prospective comparative study on the safety and effectiveness of simplified intra-cavity Pringle method and traditional Pringle method in laparoscopic hepatectomy

目的比较简化腔内Pringle法与传统Pringle法在腹腔镜肝切除术中安全性及有效性。方法选择2018年1月至2019年6月行腹腔镜肝切除术的80例患者进行前瞻性研究。按照随机数表法将患者分为简化组(简化腔内Pringle法)和传统组(传统Pringle法)各40例。采用SPSS 20.0软件对数据进行处理,围术期各项指标等计量资料以(±s)表示,采用独立样本t检验;术后并发症等计数资料比较采用χ^(2)检验;P<0.05为差异有统计学意义。结果两组患者手术时间、腹腔引流量、术中出血量、肝门阻断时间及住院时间差异无统计学意义(P>0.05)。两组患者术后7 d ALT、AST、ALB、TBIL水平相较于术前均明显接近正常(P<0.05);术后7 d简化组ALT、ALB水平均明显高于传统组(P<0.05);术后7 d两组间AST、TBIL水平比较差异无统计学意义(P>0.05)。简化组术后并发症总发生率12.5%低于传统组术后并发症总发生率为20.0%,但差异无统计学意义(P>0.05)。结论简化腔内Pringle法与传统腔外Pringle法均可有效阻断入肝血流,但简化腔内Pringle法可降低肝功能损害程度,在减少腹壁创伤方面有一定的优势。

Objective To Analyze and compare the safety and effectiveness of simplified intra-cavity Pringle method and traditional Pringle method in laparoscopic hepatectomy.Methods A prospective study was performed in 80 patients underwent laparoscopic hepatectomy in our general surgery department from January 2018 to June 2019.According to the random number table method,patients were divided into simplified group(by using simplified intra-cavity Pringle method,40 cases)and control group(by using traditional Pringle method,40 cases).Statistical analysis were performed by using SPSS 20.0 software.Perioperative indicators and other measurement data were expressed as),and examined by using independent sample t-test.Postoperative complications were compared by using theχ^(2) test;A P value of<0.05 was considered as statistically significant difference.Results There were no statistically significant differences between the two groups in terms of operation time,abdominal drainage volume,intraoperative blood loss,portal clamping time and hospital stay time(P>0.05).The levels of ALT,AST,ALB,and TBIL in both groups were significantly decreased to be normal 7 days after operation(P<0.05);The level of ALT and ALB in the simplified group were significantly higher than those in the traditional group 7 days after operation(P<0.05);There were no significant differences between the two groups in terms of AST and TBIL levels 7 days after operation(P>0.05).Total postoperative complications incidence of 12.5%in the simplified group was lower than 20.0%in the traditional group,without statistically significant difference(P>0.05).Conclusion Both the simplified intra-cavity Pringle method and the traditional extra-cavity Pringle method could effectively block blood flow within the liver,however the simplified intra-cavity Pringle method could reduce the degree of liver function damage and has certain advantages in reducing abdominal wall trauma.