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目的:探讨高频电刀在肝细胞癌(HCC)肝切除术中的应用价值。方法:将386例HCC患者分为观察组(n=199)和对照组(n=187),观察组采用120 W电凝输出功率电刀进行肝切除术,对照组采用钳夹法加超声刀肝切除。比较两组术中肝门阻断时间、手术时长、术中出血量、术中及术后输红细胞情况及术后引流、肝功能改变、术后并发症、术后住院时间等指标。结果:所有患者均顺利完成手术,观察组术中未出现因大功率高频电流引起的灼伤、心电异常等。与对照组比较,观察组手术时间(192.79 min vs.212.10 min)、肝门阻断时间(5.17 min vs.14.65 min)、术后并发症发生率(21.1%vs.34.2%)、术后红细胞输注率(25.7%vs.36.7%)、术后住院时间(8.87 d vs.12.15 d)均明显减少(均P<0.05),但术中出血量(378.56 mL vs.412.75 mL)、术中红细胞输注率(7.5%vs.7.5%)、术后拔管时间(5.83 d vs.6.29 d)无统计学差异(P>0.05);观察组术后1、3 d部分肝功能指标优于对照组(均P<0.05)。两组术后1、2、3年总生存率差异均无统计学意义(均P>0.05)。结论:大功率高频电刀用于HCC肝切除术切肝速度快、止血效果好,使用安全可靠。
Objective: To investigate the value of high frequency electric knife in hepatectomy of hepatocellular carcinoma (HCC). Methods: 386 HCC patients were divided into observation group (n = 199) and control group (n = 187). The observation group was operated with 120 W electrocoagulation power knife for hepatectomy. In the control group, Liver resection. The duration of operation, the amount of intraoperative blood loss, intraoperative and postoperative transfusion of red blood cells, postoperative drainage, changes of hepatic function, postoperative complications and postoperative hospital stay were compared between the two groups. Results: All patients were successfully completed the operation, the observation group did not appear due to high-power high-frequency current burns, ECG abnormalities. Compared with the control group, the operation time of the observation group (192.79 min vs.212.10 min), the time of hilar blocking (5.17 min vs.14.65 min), postoperative complication rate (21.1% vs.34.2%), postoperative erythrocyte (25.7% vs.36.7%), postoperative hospital stay (8.87 d vs.12.15 d) were significantly reduced (all P <0.05), but the intraoperative blood loss (378.56 mL vs.412.75 mL) The rate of erythrocyte infusion (7.5% vs.7.5%) and extubation time (5.83 d vs.6.29 d) had no statistical difference (P> 0.05) Control group (all P <0.05). There was no significant difference in the overall survival rate between the two groups at 1, 2 and 3 years (all P> 0.05). Conclusion: High-power high-frequency electrosurgical knife for HCC hepatectomy hepatectomy speed, hemostatic effect, the use of safe and reliable.