比较超声吸引刀（CUSA）联合高频电刀与超声刀在肝切除术中的安全性。

回顾性分析2011年1月至2014年1月在中山大学孙逸仙纪念医院采用CUSA联合高频电刀或超声刀行肝切除术的102例患者临床资料。根据手术方式将患者分为CUSA联合高频电刀切肝组（CUSA组，53例）和超声刀切肝组（超声刀组，49例）。其中CUSA组中，男32例，女21例；平均年龄（48±11）岁。超声刀组中，男31例，女18例；年龄（49±13）岁。所有患者均签署知情同意书，符合医学伦理学规定。患者术中均采用选择性肝门阻断法阻断肝门。观察两组患者选择性肝门阻断时间、术中出血量、术后并发症等临床指标。两组观察指标比较采用t检验或χ²检验。

CUSA组选择性肝门阻断时间为（13±2）min，明显短于超声刀组的（23±3）min（t=-19.946，P<0.05）。CUSA组术中出血量为（293±53）ml，明显少于超声刀组的（468±54）ml（t=-16.510，P<0.05）。CUSA组胆漏发生率为4%（2/53），明显低于超声刀组的16%（8/49） （χ²=4.537，P<0.05）。

与超声刀相比，CUSA联合高频电刀肝切除术中出血量更少，选择性肝门阻断时间更短，胆漏发生率更低，肝切除术的安全性明显提高。

To compare the safety of cavitron ultrasonic surgical aspirator (CUSA) combined with high-frequency electrotome versus harmonic scalpel in hepatectomy.

Clinical data of 102 patients undergoing hepatectomy using CUSA combined with high-frequency electrotome or harmonic scalpel in Sun Yat-sen Memorial Hospital of Sun Yat-sen University between January 2011 and January 2014 were retrospectively studied. The patients were divided into the hepatectomy using CUSA combined with high-frequency electrotome group (the CUSA group, n=53) and the hepatectomy using harmonic scalpel group (the harmonic scalpel group, n=49). In the CUSA group, 32 were males and 21 were females with the average age of (48±11) years old. In the harmonic scalpel group, 31 were males and 18 were females with the average age of (49±13) years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. Porta hepatis was occluded by selective porta hepatis exclusion during hepatectomy. The interval of selective portal hepatis exclusion, intraoperative blood loss and postoperative complications of the two groups were observed. The observation indexes of the two groups were compared using t test or Chi-square test.

The interval of selective portal hepatis exclusion of the CUSA group was (13±2) min, which was significantly shorter than (23±3) min of the harmonic scalpel group (t=-19.946, P<0.05). The intraoperative blood loss of the CUSA group was (293±53) ml, which was significantly less than (468±54) ml of harmonic scalpel group (t=-16.510, P<0.05). The incidence of biliary leakage of the CUSA group was 4% (2/53), which was significantly lower than 16% (8/49) of the harmonic scalpel group (χ²=4.537, P<0.05).

Compared with harmonic scalpel, CUSA combined high-frequency electrotome in hepatectomy has the advantages of less intraoperative blood loss, shorter interval of selective portal hepatis exclusion and lower incidence of biliary leakage. Thus, the safety of hepatectomy is enhanced significantly.