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find Author "陈见中" 3 results
  • Clinical significances of intraoperative methylene blue diluent injection through residual bile duct for bile leakage after hepatic hydatidosis surgery: a randomized controlled trial

    ObjectiveTo investigate the clinical significances of intraoperative methylene blue diluent injection through the residual bile duct for bile leakage after hepatic hydatidosis surgery.MethodsThe patients with hepatic hydatidosis who received the surgical treatment in this hospital from December 2018 to November 2019 were randomly divided into a study group and control group. The patients in the study group received the treatment of anatomical or nonanatomical hepatic lobectomy. The first hepatic hilum was locked, then the methylene blue diluent was injected through the residual bile duct to find the bile leakage. The drainage tube was retained in the abdominal cavity after the surgery. The patients in the control group except the white gauze was used to compress the liver wound surface for 5 min to find the bile leakage, the other treatment process was the same as the study group. The operation time, intraoperative blood loss, liver function on day 3 after the surgery (total bilirubin, alanine aminotransferase, albumin), detection rate of bile leakage during operation, postoperative complications (pulmonary infection, ascites, incision infection, bile leakage, residual cavity infection, and electrolyte disturbance), postoperative hospitalization time, and total hospitalization cost were compared between two groups.ResultsAccording to the inclusion and exclusion criteria, 67 patients were included in this study, including 32 in the study group and 35 in the control group. There were no significant differences in the baseline data such as the age, gender, preoperative complications, preoperative liver function (total bilirubin, alanine aminotransferase, albumin), and liver hydatid classification between the two groups (P>0.05). The operations were successful in the 67 patients, no perioperative death occurred. The detection rate of bile leakage during operation in the study group was higher than that in the control group (53.1% versus 17.1%, P<0.05). The postoperative hospitalization time was shorter and the total hospitalization cost was lower in the study group as compared with the control group (P<0.05). There were no significant differences in the operation time, intraoperative blood loss, liver function on day 3 after the surgery between the two groups (P>0.05). There was no case of the incision infection, bile leakage, and residual cavity infection in the study group, but there were 1, 5 and 4 cases in the control group, respectively. The incidences of incision infection and bile leakage had statistical significances between the two groups (P<0.05), and there was no significant differences in the incidences of other complications between the two groups (P>0.05).ConclusionsDetection rate of bile leakage during operation is high by intraoperative methylene blue diluent injection through the residual bile duct for bile leakage after hepatic hydatidosis surgery. It could reduce bile leakage, shorten postoperative hospitalization time, and reduce total hospitalization cost.

    Release date:2020-10-21 03:05 Export PDF Favorites Scan
  • 肝圆韧带修补下腔静脉治疗复杂肝泡型包虫病1例报道

    目的探讨在CT三维重建辅助下利用肝圆韧带修补下腔静脉个体化治疗复杂肝泡型包虫病的临床效果。方法术前采用免费软件CT三维可视化技术进行精准评估,经多学科协作团队讨论后制定手术方案,行标准肝包虫病根治术,再利用肝圆韧带修补下腔静脉缺损。结果本例患者术前三维可视化技术评估精确,术中与术前讨论情况基本一致,术中利用肝圆韧带修补下腔静脉缺损。手术顺利,术中出血量约600 mL,术后恢复顺利。随访19个月时患者情况良好,无包虫病复发及下腔静脉狭窄。结论在基层医院医生可利用免费软件行术前CT三维重建,可较好地满足手术需要;应用肝圆韧带修补下腔静脉缺损后围手术期及中远期疗效良好,为复杂肝泡型包虫病的个体化治疗提供了一种重要选择。

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  • Study of transversus abdominis plane block as part of multimodal analgesia in enhanced recovery after surgery program for patients with hepatic hydatidosis

    ObjectiveTo investigate the clinical effect of transversus abdominis plane (TAP) block as part of multimodal analgesia in enhanced recovery after surgery (ERAS) program for patients with hepatic hydatidosis. MethodsThis study was a randomized controlled trial (The registration number was ChiCTR2100053689). According to the established inclusion and exclusion criteria, the patients diagnosed with hepatic hydatidosis treated in the People’s Hospital of Aba Tibetan and Qiang Autonomous Prefecture from October 2019 to August 2021 were prospectively included. The odd and even by obverse and reverse of coin was adopted to assign into the study group and the control group, respectively. The patients in the study group were treated with ERAS + TAP block + patient controlled intravenous analgesia (PCIA) + tramadol and the patients in the control group were treated with ERAS + PCIA + tramadol. The intraoperative and postoperative statuses of the two groups were compared. ResultsA total of 64 patients were enrolled in this study, including 32 patients in the study group and 32 patients in the control group. There were no statistical differences in the baseline data such as the age, gender, preoperative complications, preoperative liver function, and liver hydatid type between the two groups (P>0.05). The operations of 64 patients were performed successfully, and there was no perioperative death. There were no statistical differences in the operation time, intraoperative bleeding, and operation mode between the two groups (P>0.05). Compared with the control group, the points of visual analogue scale of postoperative pain on day 1 and 2 were lower (P<0.05), the dosage of tramadol within 2 d after operation and hospitalization expenses were less (P<0.05), and the getting out of bed time, eating liquid diet time, postoperative exhaust time, and total hospital stay were shorter (P<0.05) in the study group. The total complication rate of the study group was lower than that of the control group [28.1% (9/32) vs. 78.1% (25/32), χ2=16.063, P<0.001]. The comprehensive complication index was positively correlated with the total hospital stay (r=0.941, P<0.001) and hospitalization expenses (r=0.958, P<0.001). ConclusionPreliminary results of this study suggest that multimodal analgesia included TAP block is effective in ERAS, and could shorten hospital stay and reduce hospitalization expenses.

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