Clinical application of absorbable clips in hepatectomy
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摘要: 目的探讨可吸收夹应用在肝切除中减少术中出血、手术时间和术后并发症的可行性。方法回顾性分析2010年1月至2012年7月本科收治的315例肝切除术患者资料。应用可吸收夹149例(研究组),常规方法 166例(对照组)。观察术中出血量和手术时间,术后是否发生胆漏、手术部位感染、肝功能衰竭、耗材和住院总费用、是否手术创面活动性出血而再次手术。计量资料采用t检验,计数资料采用卡方检验和fisher确切概率法。结果研究组和对照组术中出血量分别为(344.59±116.78)、(582.90±216.17)ml,两组比较差异有统计学意义(t=11.95,P<0.05);手术时间分别为(205.56±45.72)、(270.84±33.87)min,两组比较差异有统计学意义(t=14.47,P<0.05);手术耗材费用分别为(2849.36±84.75)、(567.27±56.38)元,两组比较差异有统计学意义(t=16.21,P<0.05);住院总费用分别为(39 344.52±521.21)、(38 872.43±426.05)元,两组比较差异无统计学意义(P>0.05)...Abstract: Objective To evaluate the feasibility of application of absorbable clips in hepatectomy for reducing intraoperative bleeding, operation time, and postoperative complications. Methods A retrospective analysis was performed on the clinical data of 315 patients who underwent hepatectomy in the department of hepatobiliary surgery from January 2010 to July 2012. These patients were divided into observation group ( n = 149) , among whom absorbable clips were used in hepatectomy, and control group ( n = 166) , among whom the conventional surgical approach was used. Intraoperative bleeding, operation time, bile leakage, surgical site infection, liver failure, material and hospitalization expenses, and reoperation due to active bleeding at surgical wound were evaluated. Continuous data were analyzed by t test, and categorical data were analyzed by chi-square analysis and Fisher's exact test. Results The intraoperative bleeding was significantly less in the observation group than in the control group ( 344. 59 ± 116. 78 vs 582. 90 ± 216. 17 ml, t = 11. 95, P < 0. 05) . The operation time was significantly shorter in the observation group than in the control group ( 205. 56 ± 45. 72 vs 270. 84 ± 33. 87 min, t = 14. 47, P < 0. 05) . The material expenses were significantly more in the observation group than in the control group ( 2849. 36 ± 84. 75 vs 567. 27 ± 56. 38 yuan, t =16. 21, P < 0. 05) , but there was no significant difference in hospitalization expenses between the observation group and control group ( 39 344. 52 ±521. 21 vs 38 872. 43 ±426. 05 yuan, t =0, P >0. 05) . After operation, bile leakage was found in one case in the observation group and 9 cases in the control group ( χ2= 5. 765, P < 0. 05) ; surgical site infection was found in 2 cases in the observation group and in 15 cases in the control group ( χ2= 9. 104, P < 0. 05) ; liver failure was found in 2 cases in the observation group and in 11 cases in the control group ( χ2= 5. 541, P < 0. 05) . No one underwent reoperation in the observation group, versus 6 cases in the control group ( χ2=7. 91, P < 0. 05) Conclusion The application of absorbable clips in hepatectomy can reduce intraoperative bleeding, operation time, and postoperative complications.
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Key words:
- surgical equipment /
- absorbable clips /
- hepatectomy
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