目的探讨一次性水冷不粘双极电凝在肝切除中的应用效果。方法选取122例行择期肝切除的原发性肝癌(PHC)患者为研究对象,采用随机数字表法分为观察组和对照组,每组61例。观察组术中使用一次性水冷不粘双极电凝,对照组使用常规单极电凝。记录两组手术相关指标(手术时间、术中出血量、术中输血例数、住院时间)、住院期间并发症(腹水、胆漏、低蛋白血症、腹腔感染等)发生情况及两组术前、术后3 d肝功能指标,如白蛋白(ALB)、谷丙转氨酶(ALT)变化情况。结果观察组手术时间长于对照组,术中出血量、术中输血例数、住院时间均少于对照组,差异均有统计学意义(P<0.05)。与术前比较,术后两组ALB明显降低,ALT水平明显升高;且术后观察组血清ALB水平高于对照组,ALT水平低于对照组,差异均有统计学意义(P<0.05)。观察组住院期间并发症总发生率明显低于对照组,差异有统计学意义(P<0.05)。结论一次性水冷不粘双极电凝在肝切除术中的应用效果显著,可减少术中出血量,并控制输血比例,且能降低肝功能损伤程度,有利于患者预后。
ObjectiveTo investigate the efficacy of disposable water-cooled non-stick bipolar electrocoagulation for liver resection. MethodsA total of 122 patients with primary liver cancer undergoing elective hepatectomy in our hospital were selected and were divided into observation group and the control group using random number table, with 61 cases in each group. During the operation, the disposable water-cooled non-stick bipolar electrocoagulation was used in the observation group and the conventional unipolar electrocoagulation in the control group. The operation-related indicators (including operation duration, intraoperative blood loss, number of cases with intraoperative blood transfusion and hospital stay), complications during hospitalization (including ascites, bile leakage, hypoproteinemia and intra-abdominal infection) and the liver function indices [such as albumin (ALB) and alanine aminotransferase (ALT)] before operation and after 3 days of operation were recorded in both groups. ResultsThe operation duration was longer, but the intraoperative blood loss, number of cases with intraoperative blood transfusion and hospital stay were less in the observation group compared to the control group(P<0.05). The ALB levels significantly decreased and ALT levels significantly increased in both groups compared to the preoperative levels(P<0.05). After operation, the serum ALB level was higher and the ALT level was lower in the observation group compared to control group(P<0.05). The total incidence of complications during hospitalization in the observation group was significantly lower than that in the control group (P<0.05). ConclusionThe disposable water-cooling non-stick bipolar electrocoagulation achieves a significant application effect, and can reduce intraoperative blood loss, can control the proportion of cases with blood transfusion, can reduce the degree of liver function damage, and is beneficial to the prognosis of patients.