腹腔镜Pringle法联合左肝静脉阻断对左半肝切除术患者术中出血量及凝血指标的影响

Effect of Laparoscopic Pringle Method Combined with Occlusion of Left Hepatic Vein on Intraoperative Blood Loss and Coagulation Indexes in Patients Undergoing Left Hepatectomy

目的:探讨Pringle法联合左肝静脉阻断对左半肝切除术患者术中出血量及凝血指标的影响。方法:以2017年10月-2020年10月经本院收治行腹腔镜左半肝切除术82例患者病历资料做回顾性分析,循阻断方式差异实施分组,以Pringle法作对照组,以Pringle法联合左肝静脉阻断作观察组,比较两组基线资料、临床参数、凝血指标及并发症状况。结果:两组阻断时间、手术时间比较,差异无统计学意义(P>0.05),观察组术中出血量及住院时间均较对照组少或短(P<0.05);两组术后PT、APTT均稍有上升,TT及Fbg则呈一定程度下降,观察组PT、APTT、TT及Fbg变化幅度均低于对照组(P<0.05);两组并发症总发生率比较,差异无统计学意义(P>0.05)。结论:左半肝切除术患者应用Pringle法联合左肝静脉阻断有助于降低术中出血量,缩短住院时间,且凝血功能影响较低,并发症发生率较低。

Objective:To investigate the effect of Pringle method combined with occlusion of left hepatic vein on intraoperative blood loss and coagulation indexes in patients undergoing left hemihepatectomy.Method:The medical records of 82 patients who underwent laparoscopic left hepatectomy from October 2017 to October 2020 in our hospital were retrospectively analyzed,and the groups were divided according to the blocking method.The patients with Pringle method was selected as the control group,and the patients with Pringle method combined with left hepatic vein occlusion were selected as the observation group.The baseline data,clinical parameters,coagulation indicators and complications of the two groups were compared.Result:There were no statistically significant differences in blocking time and operation time between the two groups(P>0.05).The intraoperative blood loss and hospital stay in the observation group were shorter than those in the control group(P<0.05);the postoperative PT and APTT of the two groups increased slightly,while TT and Fbg decreased to a certain extent.The changes of PT,APTT,TT,and Fbg in the observation group were all lower than those in the control group(P<0.05);there was no statistically significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion:The use of Pringle method combined with occlusion of the left hepatic vein in patients undergoing left hepatectomy can help reduce intraoperative blood loss,shorten the length of hospital stay,and have a lower impact on blood coagulation function and a lower incidence of complications.