探讨超声吸引刀（CUSA）联合高频电刀在活体肝移植供肝切取中的应用价值。

回顾性分析2012年5月至2015年7月在郑州人民医院行活体肝移植的8例供者临床资料，供肝切取均采用CUSA联合高频电刀的方法。其中男4例，女4例；年龄30～56岁，中位年龄45岁。所有供者均签署知情同意书，符合医学伦理学规定。供肝切取手术中充分游离肝脏，解剖第一肝门，不阻断第一肝门血流，术中超声确定脉管走行及肝切除线，高频电刀切开肝被膜，CUSA分离肝实质。观察供者的手术时间、术中出血量、术后肝功能变化、住院时间、并发症发生情况、围手术期死亡率，并对供者进行术后随访。

本组供者均手术顺利，6例行右半肝切除术，其中1例含肝中静脉切除；2例行左半肝切除术，均不含肝中静脉切除，平均手术时间（437±96）min，术中出血量（467±216）ml，所有供者术中均未输血。供者术后1、7 d血清ALT水平分别为（221±56）、（77±25）U/L，血清TB水平分别为（34±11）、（16±6）μmol/L。术后住院时间（18±5）d，术后伤口脂肪液化1例，经保守治疗后治愈，无供者死亡。

CUSA联合高频电刀在活体肝移植供肝切取中有一定的临床应用价值，是一种安全、有效的供肝切取方法。

To explore the application value of cavitron ultrasonic surgical aspirator (CUSA) combined with high-frequency electrosurgical scalpel in liver graft procurement for living donor liver transplantation (LDLT).

Clinical data of 8 donors who underwent LDLT in Zhengzhou People's Hospital between May 2012 and July 2015 were retrospectively analyzed. CUSA combined with high frequency electrosurgical scalpel were used in the liver graft procurement of all the donors. Among the donors, 4 were males and 4 were females with the age ranging from 30 to 56 years old and the median of 45 years old. The informed consents of all donors were obtained and the local ethical committee approval was received. During the graft procurement, the liver was fully dissociated, and the first porta hepatis was dissected without blood occlusion. Blood vessel distribution and liver resection line were determined by intraoperative ultrasound examination. Liver capsule was incised with high frequency electrosurgical scalpel and liver parenchyma was seperated with CUSA. The length of operation, intraoperative blood loss, changes of liver function and length of stay after operation, incidence of complications and perioperative mortality of the donors were observed. All the donors were followed up after operation.

All donors completed the operations successfully. Six cases underwent right hemihepatectomy and one of them had middle hepatic vein resected. Two cases underwent left hemihepatectomy without resecting the middle hepatic vein. The average length of operation was (437±96) min and the intraoperative blood loss was (467±216) ml. No blood transfusion during operation was observed. The serum alanine aminotransferase (ALT) level was respectively (221±56) and (77±25) U/L, and the serum total bilirubin (TB) level at 1, 7 d after operation was respectively (34±11) and (16±6) μmol/L. The length of stay after operation was (18±5) d. Fat liquefaction of wound after operation was observed in 1 case and was cured after conservative treatment. No death was observed.

CUSA combined with high frequency electrosurgical scalpel has certain clinical application value in the liver graft procurement for LDLT. It is a safe and effective method for liver graft procurement.