目的观察S100吸收性止血绫（absorbable stanching satin S100，ASS）在肝脏外科的止血效果。方法将40例择期行肝部分切除术的患者随机分成两组，应用ASS贴敷肝断面为ASS组（n=20），肝断面不用任何局部止血材料为对照组（n=20），分别于术后2 h、12 h、24 h及72 h观察腹腔引流情况，其中重点观察引流量。结果ASS组术后腹腔引流量较对照组明显减少，差异有显著性意义（P＜0.01）;ASS组术后无漏胆发生，对照组术后有2例发生漏胆; ASS组的腹腔引流管拔管时间及平均住院日均小于对照组，但差异无显著性意义（Pgt;0.05）。结论ASS在肝脏部分切除术中具有安全、有效的止血作用，特别是对于伴有凝血机能障碍的患者。
Thirty two surgical patients with liver disease (hepatocelluar carcinoma 16, liver cirrhosis 8, obstructive jaundice 8) were studied. All of them were randomly divided into three groups for administration of different kinds of TPN during the postoperative period [group Ⅰ (TPN without fat emulsion), group Ⅱ (TPN with fat emulsion, 1g/kg body weight/day of fat), group Ⅲ (TPN with fat emulsion 2g/kg body weight/day of fat )]. Their liver function test, glucose, lipid metabolism were examined and compared during the period of TPN. Result: ①TB, ALT and AST decreased in group Ⅱ and group Ⅲ (Plt;0.05), but increased in group Ⅰ (Plt;0.05). ②The blood glucose and insulin levels were normal in group Ⅱ and groupⅢ, but showed hyperglycemia and hyperinsulinemia in group Ⅰ (Plt;0.05). ③The serum lipid, lipoprotein, apoliprotein level and LCAT activity returned to normal 6 days after operation in group Ⅱ (Plt;0.05), but not in group Ⅰ and groupⅢ (Plt;0.05). Conclusion: ①TPN with fat emulsion for surgical patients with liver disease can make more improvement on hepatic functions than TPN without fat emulsion. ②1g/kg body weight/day of fat dosage may be suitable for the patients during the period of postoperative TPN.
Objective To summarize the application and advancement of liver transplantation for hepatic metastasis from neuroendocrine tumor. Methods Domestic and overseas publications on the study of liver transplantation for hepatic metastasis from neuroendocrine tumor in recent years were collected and reviewed. Results Liver transplantation can offer good relief of symptoms, long disease-free intervals, and potential cure in individual patients with hepatic metastatic tumor. Important selection criteria are well-differentiated tumors and a low proliferation rate (Ki67＜10%). Conclusion In carefully selected patients with metastatic neuroendocrine tumors, liver transplantation is an appropriate option.
Objective To observe the effect of parenteral nutrition (PN) on the protein storage and immunofunction in patients with liver cirrhosis. Methods PN regimes consisted of nonprotein calories (NPC) 20-25 kcal/(kg·d) and nitrogen 0.15-0.20 g/(kg·d), the energy ratio of the glucose and fat emulsion was 2∶1. The PN solution was infused by total nutrition admixture (TNA), 12-16 hours per day for 7 days in 21 liver cirrhosis patients. Perior to the surgery and at 1st, 4th, 7th postoperative day, serum pre-Alb, transferrin (TSF), immunofunction (IgG, IgA, IgM, IgE, CH50, C3, C4, CD3, CD4, CD8, NKC), and nitrogen balance were tested. Results Serum pre-Alb, TSF, nitrogen balance and IgG, IgE, CH50, CD3, CD4, NKC were significantly decreased (Ｐ＜0.05), but the foregoing indices were higher than those of postoperative 1, 4d as compared with postoperative 7d. Conclusion These results bly indicated that postoperative nutritional support is safe and useful, and improve the patient’s nutritional status and immunofunction.
Objective To analyze relevant literatures of three-dimensional (3D ) imaging in liver using bibiometric analysis, and to provide a current status and hotspot in this filed in future for liver surgeon. Methods The bibliographies of liver 3D imaging from November 2007 to November 2017 in the PubMed database were downloaded. The publication years, journals, the first authors, and the frequency of subject headings+subheadings were extracted by Bicomb 2.0 software. The subject headings+subheadings appeared more than 10 times were intercepted as high frequency ones, then created the high frequency subject headings+subheadings co-occurrence matrix. SPSS 22.0 software was applied for clustering analysis with this matrix to get the topic hotspot. Results A total of 269 literatures were screened out. The research in this field reached its peak in 2016. The core area of journals contained 12 journals. There were 6 authors published at least 3 relevant literatures. The number of high frequency subject headings+subheadings was 16. The research hotspot of liver 3D imaging was precise liver surgery. Conclusion Research hotspot of application of 3D imaging in liver is precise liver surgery in recent 10 years.