【摘要】 目的通过捆绑式阻断法与Pringle法对比,探讨捆绑式肝局部血流阻断法在腹腔镜肝切除术中的可行性。方法 2003年1月至2011年1月佛山市第一人民医院肝胆外科将收治的62例行腹腔镜肝肿瘤切除术的病人随机分为Pringle组(30例)与捆绑式阻断组(32例),对比分析两组在术中出血量、术前与术后肝功能变化、局部及全身并发症发生率、手术时间、住院时间的差异。结果两组术中出血量、围手术期并发症发生率、术前及术后1、3、7d白蛋白(ALB)、总胆红素(TBIL)比较,差异无统计学意义(P>0.05)。捆绑式阻断组术前及术后1、3、7d丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)比较差异有统计学意义(P<0.05)。两组住院时间比较,捆绑式阻断组明显低于Pringle组(P<0.05)。结论捆绑式阻断法止血效果确切,对肝功能的损害轻,术后恢复快,缩短住院时间,是一种安全、可靠、可行的血流阻断方法。更多还原

【Abstract】 Objective To evaluate the feasibility of tourniquet method in laparoscopic hepatectomy compared with Pringle maneuver. Methods Sixty-two patients performed laparoscopic hepatectomy between January 2003 and January 2011 in the Department of General Surgery, the First People’s Hospital of Foshan City were divided into Pringle group (30 patients) and tourniquet group (32 patients) randomly. The changes of preoperative and postoperative liver function, intraoperative blood loss, complications, operation time and hospital stay between the two groups were compared. Results No significant difference was found in operative blood loss, perioperative complications, the TBIL and ALB before operation and on the first, third and seventh day after operation between two groups (P>0.05). There was significant difference in ALT and AST before operation and on the first, third and seventh day after operation between two groups (P<0.05). Patients in tourniquet group had significantly faster recovery of liver function than those in Pringle group (P<0.05). The postoperative hospital stay of tourniquet group was significantly shorter than that of Pringle group (P<0.05). Conclusion Tourniquet method can limit operative blood loss effectively with quicker recovery and shorter hospital stay, which is safe, efficient and feasible for patients performed laparoscopic hepatectomy.更多还原