简介：目的比较使用大功率高频电刀与物理钳夹联合超声刀行肝叶切除治疗原发性肝癌(PLC)患者的手术效果。方法2013年8月~2016年8月在我院接受肝叶切除治疗的139例PLC患者,观察组(n=72)和对照组(n=67),在72例观察组患者使用大功率高频电刀,在67例对照组使用物理钳夹联合超声刀行肝叶切除,比较两组手术效果。结果观察组肝门阻断时间、出血量、手术时间分别为(11.5±4.8)min、(317.9±68.2)ml、(161.3±41.5)min,显著低于对照组【分别为(19.6±5.7)min、(435.9±51.6)ml、(186.7±40.4)min,P<0.05】;术后1w,观察组血清ALT和AST水平分别为(237.8±85.6)U/L和(133.4±47.4)U/L,显著低于对照组【分别为(311±102.5)U/L和(186.8±55.9)U/L,P<0.05】;术后观察组患者胆漏发生率为2.8%,显著低于对照组的10.4%(P<0.05)。结论使用大功率高频电刀用于PLC患者肝叶切除术具有手术时间短、出血量少的特点,并发症发生率更低,安全性明显提高。

简介：AIMtotestthefeasibilityandperformanceofanoveluppergastrointestinal(GI)capsuleendoscopeusinganurse-ledprotocol.METHODSWeconductedaprospectivecohortanalysisofpatientswhodeclinedgastroscopy(oesophagogastroduodenoscopy,OGD)butwhoconsentedtoupperGIcapsuleendoscopy.PatientsswallowedtheupperGIcapsulefollowingingestionof1literofwater(containingsimethicone).AseriesofpositionalchangeswereusedtoexploittheeffectsofwaterflowandmovetheupperGIcapsulefromonegravity-dependentareatoanotherusinganurse-ledprotocol.Capsuletransittime,videoreadingtime,mucosalvisualisation,pathologydetectionandpatienttolerancewasevaluated.RESULTSFiftypatientswereincludedinthestudy.Themeancapsuletransittimesintheoesophagusandstomachwere28sand68minrespectively.Visualisationofthefollowingmajoranatomicallandmarkswasachieved(graded1-5:Poortoexcellent):Oesophagus,4.8(±0.5);gastro-oesophagealjunction(GOJ),4.8(±0.8);cardia,4.8(±0.8);fundus,3.8(±1.2);body,4.5(±1);antrum,4.5(±1);pylorus,4.7(±0.8);duodenalbulb,4.7(±0.7);secondpartoftheduodenum(D2),4.7(±1).TheupperGIcapsulereachedD2in64%ofpatients.Themeanvideoreadingtimewas48minwithstandardplaybackmodeand20minusingQuickview(p=0.0001).NopathologywasmissedusingQuickview.Proceduraltolerancewasexcellent.NocomplicationswereseenwiththeupperGIcapsule.CONCLUSIONTheupperGIcapsuleachievedexcellentviewsoftheupperGItract.FuturestudiesshouldcomparethediagnosticaccuracybetweenupperGIcapsuleandOGD.