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[1]張小進 沈佳佳 杜蘇明 江哲龍 潘 凡 江 藝.射頻消融在嚴(yán)重肝破裂術(shù)中的應(yīng)用價值分析[J].福建醫(yī)藥雜志,2019,41(02):1-4.
　ZHANG Xiaojin,SHEN Jiajia,DU Suming,et al.Application value of radiofrequency ablation in severe hepatorrhexis[J].FUJIAN MEDICAL JOURNAL,2019,41(02):1-4.
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射頻消融在嚴(yán)重肝破裂術(shù)中的應(yīng)用價值分析()
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《福建醫(yī)藥雜志》[ISSN:1002-2600/CN:35-1071/R]

卷:
41
期數(shù):
2019年02期
頁碼:
1-4
欄目:
臨床研究
出版日期:
2019-01-30

文章信息/Info

Title:
Application value of radiofrequency ablation in severe hepatorrhexis
文章編號:
1002-2600(2019)02-0001-04
作者:
張小進 沈佳佳 杜蘇明 江哲龍 潘 凡 江 藝1
中國人民解放軍聯(lián)勤保障部隊第九○○醫(yī)院肝膽外科(福州 350025)
Author(s):
ZHANG Xiaojin;  SHEN Jiajia;  DU Suming;  JIANG Zhelong; PAN Fan; JIANG Yi.
Department of Hepatobiliary Surgery, Chinese Peoples Liberation Army Joint Logistics Support Force No.900 Hospital, Fuzhou,Fujian 350025, China
關(guān)鍵詞:
創(chuàng)傷性肝破裂;  射頻消融
Keywords:
traumatic liver rupture;  radiofrequency ablation
分類號:
R657.3
文獻標(biāo)志碼:
A
摘要:
目的 探討射頻消融在嚴(yán)重肝破裂術(shù)中的應(yīng)用價值和安全性。方法 回顧性分析2016 年1月至 2018年10月在我院因嚴(yán)重肝破裂(Ⅲ、Ⅳ、Ⅴ級)手術(shù)治療的24例患者臨床資料。根據(jù) 是否應(yīng)用射頻消融止血分為常規(guī)組15例和射頻組9例。觀察兩組患者術(shù)中出血量、肝門阻斷時 間、圍手術(shù)期肝功能恢復(fù)情況及并發(fā)癥發(fā)生情況等。結(jié)果 與常規(guī)組對比:射頻組肝門阻斷時間 顯著縮短[(38.5±8.42)min vs(15.6±4.91)min,P<0.05],術(shù)中出血顯著減 少[(820±364)mL vs(459±322)mL, P<0.05]; 術(shù)后第3天血清ALT顯著降低 (562±243)U/L vs(319±124)U/L,AST顯著降低(426±126)U/L vs(304±82) U/L,術(shù)后第3天其他肝功能指標(biāo)及術(shù)后第1天及術(shù)后第7天各項肝功能指標(biāo)比較的差異無統(tǒng)計學(xué) 意義; 術(shù)后膽漏、再出血、胸腔積液、腹腔感染等并發(fā)癥發(fā)生率比較的差異亦無統(tǒng)計學(xué)意義。 結(jié)論 在Ⅳ、Ⅴ級肝破裂手術(shù)中應(yīng)用射頻消融止血可以縮短肝門阻斷時間,減少術(shù)中出血,有利 于早期肝功能恢復(fù),是一種安全、有效的方法。
Abstract:
Objective To investigate the value and safety of radiofrequency ablation in severe liver rupture.Methods To conduct retrospective analysis of the clinical data of 24 patients with severe liver rupture(grade Ⅲ, Ⅳ and Ⅴ)who were treated in No.900 Hospital of the Logistic Support Forces between January 2016 to October 2018.The patients were divided into routine group(15 cases)and radiofrequency group(9 cases)according to whether radiofrequency ablation was used for hemostasis.To observe the amount of bleeding in operation, the time of hepatic hilus occlusion, the recovery of liver function and the occurrence of complications in perioperative period of the two groups of patients.Results Compared with the routine group,the time of hepatic hilus occlusion of the radiofrequency group was significantly shortened[(38.5±8.42)min vs (15.6±4.91)min,P<0.05], and the intraoperative bleeding was significantly decreased [(820±364)mL vs(459±322)mL, P<0.05].On the third day after operation, the serum ALT decreased significantly(562±243)U/L vs(319±124)U/L and the AST obviously decreased(426±126)U/L vs(304 ±82)U/L.There was no statistical significance in difference between other liver function indexes on the third day after operation and liver function indexes on the first day and the seventh day after operation.There was also no statistical significance in complications such as bile leakage, rebleeding, pleural effusion, abdominal cavity infection and so on after operation.Conclusion Applying radiofrequency ablation for hemostasis in grade Ⅳ and Ⅴ hepatic rupture operation is a safe and effective method,which can shorten the time of hepatic hilus occlusion,reduce intraoperative bleeding,and facilitate the early recovery of liver function.

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備注/Memo

備注/Memo:
基金項目:福建省科技計劃軍民共建(社發(fā))引導(dǎo)性項目(2016Y5006); 全軍后勤課題面上項目(CNJ15J002); 福州總醫(yī)院院內(nèi)課題(2015L03) 1 通信作者,Email:[email protected]
更新日期/Last Update: 2019-01-30