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结扎速血管闭合系统在Ⅲ、Ⅳ度痔切除术中的应用 被引量:1

Preliminary application of LigaSure vessel sealant system in hemorrhoidectomy for patients with Grade 3 and Grade 4 hemorrhoids
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摘要 目的探讨结扎速血管闭合系统(Liga Sure)在Ⅲ、Ⅳ度痔切除术中的应用价值。方法65例Ⅲ、Ⅳ度痔患者,其中男41例、女24例,在局麻下实施LigaSure痔切除术。观察手术时间、术中及术后出血量、术后疼痛和并发症情况。结果65例手术均获得成功。手术时间为5~25min(9.7±4.6min)。术后疼痛评分:术后4h为1~7(3.7±1.7),术后24h为0~5(1.9±1.3)。术后3天除4例评分在3~5以外,其他患者评分均在3以下。术后7天有5人评分为1~3,余患者均无疼痛主诉。术后2个月时所有患者均无疼痛主诉。9例(15.8%)患者术中出血量小于15ml,其余56例(86.2%)术中无明显出血。术后有1例因出血给予再处理,18例(27.7%)仅表现为少量血性渗出。术后6例出现短期排便轻度失禁,无严重并发症发生。结论LigaSure用于痔切除术止血效果良好,手术时间短,患者术后疼痛轻。 Objective To evaluate the use of LigaSure vessel sealant system on hemorrhoidectomy for the patients with grade 3 and grade 4 hemorrhoids. Methods Sixty five patients with hemorrhoids (41 males and 24 females), among whom 46 cases were grade 3 and 19 cases were grade 4, tmderwent hemorrhoidectomy under local anesthesia with the use of LigaSure vessel sealant system. The time consumed for operation and the blood volume lost during and after operation were recorded. Postoperative pain was assessed by means of visual analog score (1-10). The patients were followed up for 2 months. Results The operations were performed successfully in all patients. The time consumed was 5-25 minutes (9. 7±4.6 minutes). The pain scores at 4 hours and 24 hours after operation were 1-7 (2. 7±1.7) and 0-5 (1.9±1.3), respectively. On the third day after operation, only 4 cases had a pain score of 3 to 5, in the remaining 61 cases the score was under 3. On the seventh day after operation, only 5 patients had pain scores of 1 to 3. No patients complained pain about 2 months later. The volume of blood loss in 9 cases was less than 15rnl (15. 8%), and in the remaining 56 cases there was no apparent blood loss during the operation. Only one patient was re-operated for bleeding after operation, and in 18 (27. 7%) patients there was only oozing of blood. Mild incontinence occurred in 6 patients shortly after operation, and no severe complications occurred. Conclusions LigaSure vessel sealant system shows the advantage of good haemostatic effect, less time consuming for operation, and less pain after operation for the treatment of patients with Grade 3 and Grade 4 hemorrhoids.
出处 《解放军医学杂志》 CAS CSCD 北大核心 2007年第5期515-516,共2页 Medical Journal of Chinese People's Liberation Army
关键词 痔切除术 LIGASURE 手术 结扎速血管闭合系统 hemorrhoids hemorrhoidectomy LigaSure operation
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参考文献6

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同被引文献15

  • 1钟克力,王东,潘凯,汪迎,王晓学.Ligasure血管闭合系统在痔切除手术中的应用[J].中华胃肠外科杂志,2006,9(3):247-249. 被引量:7
  • 2臧传波,罗成华,李荣,孔庆龙,王艳.应用LigaSure血管闭合系统行痔切除19例临床分析[J].中国实用外科杂志,2006,26(12):968-968. 被引量:3
  • 3钟玉莲,陈丽莉,陈秀英,吴仙蓉,赖东明.吻合器痔上黏膜环形切除术与Ligasure治疗痔病术后并发症的对比[J].中华护理杂志,2007,42(4):313-314. 被引量:11
  • 4钟玉莲,陈丽莉,陈秀英.Ligasure技术治疗痔患者的护理[J].护理学杂志,2007,22(16):34-35. 被引量:1
  • 5G. Basdanis,V. N. Papadopoulos,A. Michalopoulos,S. Apostolidis,N. Harlaftis.Randomized clinical trial of stapled hemorrhoidectomy vs open with Ligasure for prolapsed piles[J]. Surgical Endoscopy . 2005 (2)
  • 6S. Y. Kwok F.R.A.C.S., F.R.C.S. (Edinb.),C. C. Chung F.R.C.S. (Edinb.),K. K. Tsui M.R.C.S. (Edinb.),M. K. W. Li F.R.C.S. (Engl.), F.R.C.S. (Edinb.).A Double-Blind, Randomized Trial Comparing LigasureTM and Harmonic ScalpelTM Hemorrhoidectomy[J]. Diseases of the Colon & Rectum . 2005 (2)
  • 7P. A. Campbell,A. B. Cresswell,T. G. Frank,A. Cuschieri.Real-time thermography during energized vessel sealing and dissection[J]. Surgical Endoscopy . 2003 (10)
  • 8Ernest J. Franklin M.D.,Seema Seetharam M.R.C.S.,Jennifer Lowney M.D.,Paul G. Horgan Ph.D..Randomized, Clinical Trial of Ligasure? vs. Conventional Diathermy in Hemorrhoidectomy[J]. Diseases of the Colon & Rectum . 2003 (10)
  • 9G. Milito,M. Gargiani,F. Cortese.Randomised trial comparing LigaSure haemorrhoidectomy with the diathermy dissection operation[J]. Techniques in Coloproctology . 2002 (3)
  • 10Lee W J,Chen TC,Lai IRet al.Randomized clinical trial of Li-gasure versus conventional surgery for extended gastric cancer resec-tion. British Journal of Surgery . 2003

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