双边滴水双极电凝法和传统钳夹法断肝技术的对比研究

Comparative study of bilateral water-dripping bipolar electrocoagulation and traditional clamping method in liver resection

目的探讨双边滴水双极电凝法在肝细胞癌患者肝切除术中行肝创面局部止血的安全性及有效性。方法选择2020年1月至2021年12月在崇州市人民医院和四川省人民医院肝胆外科收治的120例肝细胞癌切除术患者作为研究对象,根据术中行肝创面局部止血方式将患者分为研究组和对照组,每组60例,研究组采用双边滴水双极电凝肝切除术治疗,对照组采用单纯钳夹法断肝术治疗,比较两组患者的治疗效果并分析相关的临床指标。结果研究组患者并发症总发生率低于对照组,术后的肝功能相关指标谷丙转氨酶(ALT)和谷草转氨酶(AST)均优于对照组(P<0.05),而且研究组患者的手术时间、手术相关费用、术后腹腔引流量、输血率、术中出血量均低于对照组,差异均有统计学意义(P<0.05)。两组患者经治疗后的总胆红素(TBIL)没有发生显著的变化(P>0.05)。结论双边滴水双极电凝肝切除术临床治疗效果明显优于单纯钳夹法断肝术,可以有效改善肝癌患者的肝功能,而且术后并发症发生率较低,可降低疾病负担。

Objective To investigate the safety and effectiveness of bilateral water-dripping bipolar electrocoagulation for local hemostasis of hepatic wound in liver resection of patients with hepatocellular carcinoma.Methods 120 patients with hepatocellular carcinoma undergoing hepatectomy in Hepatobiliary Surgery Departments of People’s Hospital of Chongzhou City and People’s Hospital of Sichuan from January 2020 to December 2021 were selected as the objects of study,all patients were divided into study group and control group according to the methods of intra-operative local hemostasis of liver wounds,with 60 cases in each group.The study group were treated with bilateral water-dripping bipolar electrocoagulation hepatectomy,and the control group were treated with traditional clamping method in liver resection.The treatment effects were compared between the two groups,and related clinical indexes were analyzed.Results The total incidence of complications in the study group was lower than that in the control group,and the indicators of liver function after operation in the study group,alanine aminotransferase(ALT)and aspartate transaminase(AST),were better than those in the control group(P<0.05),and the operation time,operation-related costs,postoperative abdominal drainage,blood transfusion rate,and blood loss in the study group were lower than those in the control group,and the differences were all statistically significant(P<0.05).There was no significant change in the total bilirubin(TBIL)of the two groups after treatment(P>0.05).Conclusion Bilateral water-dripping bipolar electrocoagulation hepatectomy has significantly better clinical treatment effect than that of traditional clamping in liver resection,which can effectively improve the liver function of patients with liver cancer and reduce the disease burden with the lower incidence of postoperative complications.