[Liver hemostasis using a dry electrocautery or greased with lidocaine or neomycin or glycerin or vaseline, in rabbit].
[Liver hemostasis using a dry electrocautery or greased with lidocaine or neomycin or glycerin or vaseline, in rabbit].
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发表时间：
2009
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通讯作者：
Argos Soares de Matos Filho;A. Petroianu;L. Alberti;P. Vidigal;Daniele dos Reis;Davi Machado de Souza
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作者：
Argos Soares de Matos Filho;A. Petroianu;L. Alberti;P. Vidigal;Daniele dos Reis;Davi Machado de Souza
目的探讨干式电灼术和用利多卡因凝胶、新霉素油、甘油洗剂或凡士林油涂抹的电灼术对肝段切除术后肝实质止血和愈合的影响。方法兔肝部分切除后，随机分为6组，每组10只：1组：未处理组；2组：干式电灼组；3组：利多卡因凝胶电灼组；4组：新霉素膏组；5组：甘油洗剂组；6组：凡士林膏组。测定切除的肝脏重量、出血量和止血时间。24小时后每组再手术5只，7天后再手术5只，取肝创面活检，探查腹腔。分别于手术前和再次手术前检测红细胞水平、肝功能和肝功能损伤指标。结果利多卡因凝胶和甘油洗剂减少出血量和达到止血时间，并传导电灼术的热能，24小时后出现细胞水样变性，7天后肝组织出现较深的坏死。所有物质都提高了转氨酶的浓度。这些值在最多七天后恢复正常。结论利多卡因凝胶涂布和甘油洗剂电灼术是肝实质止血最有效的方法。
OBJECTIVE To assess the hemostasis and healing of the hepatic parenchyma after segmental hepatectomy, using a dry electrocautery or an electrocautery greased with lidocaine gel, neomycin pomade, glycerin lotion, or a vaseline pomade. METHODS Rabbits were submitted to partial hepatectomy and divided into six groups of 10 animals each: Group 1: untreated; Group 2: treated with a dry electrocautery; Group 3: treated with an electrocautery greased with lidocaine gel; Group 4: with neomycin pomade; Group 5: with glycerine lotion; Group 6: with vaseline pomade. Resected liver weight, bleeding volume and time spent to achieve hemostasis were determined. Five rabbits from each group were re-operated upon after 24 hours and five after 7 days in order to obtain a biopsy of the hepatic wound and to explore he abdominal cavity. Red blood cell levels and markers of hepatic function and injury were determined before surgery and before re-operation. RESULTS Lidocaine gel and glycerine lotion reduced the bleeding volume and the time to achieve hemostasis and conducted the thermal energy of the electrocautery, causing hydropic cell degeneration after 24 hours and deeper necrosis of hepatic tissue after 7 days. All substances increased the aminotransferase concentrations. These values returned to normal after a maximum of seven days. CONCLUSION The electrocautery coated with lidocaine gel and glycerine lotion were the most effective methods for the hemostasis of hepatic parenchyma.