【摘要】：目的:本實(shí)驗(yàn)使用高頻軟組織焊接儀和超聲刀行大鼠肝左外葉部分切除術(shù),經(jīng)測量手術(shù)時間、出血量、工作溫度、熱損傷范圍、肝功能變化等指標(biāo),驗(yàn)證高頻軟組織焊接儀行肝部分切除的有效性和安全性。方法:1.標(biāo)本選擇:選取雄性Wistar大鼠48只,體重范圍190-210g,給予普通飼料、自由飲水,適應(yīng)性飼養(yǎng)1周后隨機(jī)分組(實(shí)驗(yàn)組與對照組)。實(shí)驗(yàn)前禁食12h僅給予飲用水,在各項(xiàng)工作準(zhǔn)備完成后,以5%水合氯醛7ml/kg腹腔注射麻醉行開腹肝左外葉部分切除術(shù)。2.最高溫度測量:使用紅外熱像儀測量軟組織高頻焊接儀切割肝組織時產(chǎn)生的最高溫度:3.手術(shù)時間:使用秒表計(jì)算開腹至關(guān)腹所用手術(shù)時間;4.出血量:采用術(shù)前及術(shù)后紗布稱重的方法粗略比較兩組大鼠術(shù)中的出血量,術(shù)中出血量(g)=術(shù)后紗布重量(g)-術(shù)前紗布重量(g),出血量(ml)=術(shù)中出血重量(g)/l。5.熱損傷范圍:術(shù)后分批處死大鼠,取第一天處死大鼠的肝臟切緣用甲醛緩沖液固定,石蠟包埋,蘇木精-伊紅(hematoxylin-eosin staining,HE)染色,由病理科醫(yī)生觀察病理變化并測量熱損傷范圍;6.大鼠肝功能變化:于實(shí)驗(yàn)前抽取各組大鼠眼內(nèi)眥靜脈血,于3000轉(zhuǎn)/分鐘離心后取血清,送至南方醫(yī)科大學(xué)珠江醫(yī)院檢驗(yàn)科檢測血清丙氨酸氨基轉(zhuǎn)移酶(ALT),血清天冬門氨酸氨基轉(zhuǎn)移酶(AST),并于術(shù)后1天、3天、7天分批處死后心臟取血再次送檢。7..統(tǒng)計(jì)學(xué)方法:使用SPSS 20.0軟件進(jìn)行統(tǒng)計(jì)學(xué)分析,其中計(jì)量資料以x±s表示,采用SNK檢驗(yàn)兩兩比較,采用t檢驗(yàn)比較組間數(shù)據(jù),P0.05表示差異有統(tǒng)計(jì)學(xué)意義。結(jié)果:1、手術(shù)時間:實(shí)驗(yàn)組平均手術(shù)時間為(9.05±0.25)min,對照組為(8.87±0.40)min,P0.05,二者無顯著差異。2、術(shù)中平均最高溫度:實(shí)驗(yàn)組術(shù)中平均最高溫度為(78.63±8.86)℃,對照組術(shù)中平均最高溫度為(125.35±9.52)℃,P0.05,二者差異明顯,高頻焊接儀術(shù)中最高工作溫度低于超聲刀。3、術(shù)中出血量:實(shí)驗(yàn)組術(shù)中平均出血量為(0.63±0.05)ml,對照組術(shù)中平均出血量為(0.61±0.05)ml,P0.05,二者無統(tǒng)計(jì)學(xué)差異。4、肝臟切緣熱損傷范圍:實(shí)驗(yàn)組肝臟切緣病理損傷范圍為(1.13±0.26)mm,對照組肝臟切緣病理損傷范圍為(1.69±0.29)mm,P0.05,二者差異明顯,高頻焊接儀組肝臟熱損傷程度小于超聲刀。5、術(shù)前術(shù)后肝功能變化情況:術(shù)后第一天及第七天,實(shí)驗(yàn)組與對照組肝臟AST、ALT變化程度比較P0.05,無統(tǒng)計(jì)學(xué)差異,第三天AST、ALT變化中,高頻焊接儀組變化小于超聲刀組,P0.05。結(jié)論:高頻軟組織焊接儀行Wistar大鼠肝臟左外葉部分切除術(shù)中具有一定的安全性和有效性。
[Abstract]:Objective: to study the effect of high frequency soft tissue welder and ultrasonic knife on the left lateral lobectomy of the rat liver, and to measure the operation time, blood loss, working temperature, the range of thermal injury and the changes of liver function. To verify the effectiveness and safety of partial hepatectomy with high frequency soft tissue welder. Method 1: 1. Specimen selection: 48 male Wistar rats were randomly divided into two groups (experimental group and control group). Drinking water was given for 12 hours before fasting. After the preparation of the work, 5% chloral hydrate 7ml/kg was injected intraperitoneally to perform partial resection of the left lateral lobe of the open liver. Maximum temperature measurement: use the infrared thermograph to measure the highest temperature produced by cutting liver tissue by using an infrared thermograph. Operation time: use stopwatch to calculate the operation time used to open to close abdomen. Bleeding volume: the intraoperative bleeding volume (g) of the two groups was roughly compared by gauze weighing before and after operation. The intraoperative bleeding volume (g) = postoperative gauze weight (g)-preoperative gauze weight (g),) bleeding volume (ml) = intraoperative bleeding weight (g) / L. 5). The range of heat injury: the rats were killed in batches after operation. The liver incised margin was fixed with formaldehyde buffer solution, embedded in paraffin, stained with hematoxylin-eosin staininghe. Pathological changes were observed by pathologists and the range of thermal injury was measured. The changes of liver function in rats: the blood samples were drawn from the intraocular canthus vein of rats in each group before the experiment, and the serum was collected after centrifugation at 3000 rpm. Serum alanine aminotransferase (alt) and aspartate aminotransferase (AST) were detected in the laboratory of Zhujiang Hospital of Southern Medical University. Statistical methods: SPSS 20.0 software was used for statistical analysis, in which the measurement data were expressed as x 鹵s, SNK test was used to compare the two groups, and t test was used to compare the difference between groups (P0.05). Results: the average operative time was (9.05 鹵0.25) min in the experimental group and (8.87 鹵0.40) min in the control group (P 0.05). There was no significant difference between the two groups. The mean intraoperative maximum temperature was (78.63 鹵8.86) 鈩，

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