超声吸引刀结合双极射频止血系统在肝癌切除术中的应用研究

Application of cavitron ultrasonic surgical aspirator combined with a saline-coupled bipolar sealer Aquamantys~? in hepatectomy for primary liver cancer

目的探讨超声吸引刀(Cavitron ultrasonic surgical aspirator,CUSA)结合Aquamantys~?双极射频止血系统在原发性肝癌切除术中的应用价值。方法对郑州大学人民医院2017年5月—2018年6月进行原发性肝癌切除的113例患者进行回顾性分析,根据手术方式将患者分为CUSA联合Aquamantys~?系统组(A组,n=40)和常规钳夹法(Clamp crushing method)组(B组,n=73)。观察两组手术时间、术中出血量及输血量、住院时间、术后肝功能及并发症发生情况。结果与B组比较,A组手术时间较长,术中出血量和输血量明显减少。A组术后第1天、第5天引流量均少于B组,术后平均住院时间短于B组。两组患者术后并发症发生率无差别,均未发生死亡。结论应用超声吸引刀(CUSA)联合双极射频止血系统行肝癌切除术,能够减少术中出血,加快术后康复。

Objective To evaluate the value of Cavitron ultrasonic surgical aspirator(CUSA)combined with a saline-coupled bipolar sealer Aquamantys~?in hepatectomy of primary liver cancer.Methods Totally 113 patients who underwent hepatectomy of primary liver cancer from May 2017 to June 2018 in People’s Hospital of Zhengzhou University were retrospectively analyzed.Patients were divided into CUSA combined with Aquamantys~?system group(group A)and Clamp crushing method group(group B).The operative time,intraoperative blood loss and blood transfusion,hospitalization time,postoperative liver function and complications were observed.Results Compared with group B,the operation time of group A was longer,the amount of blood loss and blood transfusion in group A were significantly decreased than those in group B.On the first day and the fifth day after operation,the drainage volume in group A was less than that in group B.The average postoperative hospitalization stay was shorter than that in group B.There was no difference in the incidence of postoperative complications and no death occurred in two groups.Conclusion The application of cavitron ultrasonic surgical aspirator(CUSA)combined with a saline-coupled bipolar seaIer in hepatectomy of primary liver cancer can reduce intraoperative bleeding and accelerate postoperative recovery,which should be further popularized.