自制肝门阻断带在腹腔镜肝脏手术中的应用护理小经验

Nursing Experiences in the Application of Self-Made Hepatic Portal Occlusion Bands in Laparoscopic Liver Surgery

摘要: 目的：总结18Fr硅橡胶引流管自制自锁式肝门阻断带在腹腔镜肝切除术中的实操应用及标准化护理经验，通过临床实践优化肝门阻断操作流程及标准化护理要点，在保障手术安全的前提下降低耗材支出、减少缺血相关并发症，节约耗材成本。方法：选取2026年1月~2026年7月本院43例腹腔镜肝切除术患者，术中统一使用自制硅橡胶肝门阻断带，规范制作方法、术中放置、固定、阻断时长管理、术中循环监护、术后耗材核查全流程护理操作，记录耗材成本、操作耗时、梳理实操护理要点。结果：自制阻断带制作简单，耗材成本3.5元，单次操作(阻断 + 解除)平均耗时1.2 min；本组43例患者无肝门血管、胆管压迫损伤，未出现阻断带滑脱、断裂、腹腔异物残留等不良事件。结论 自制硅胶肝门阻断带制作简便、安全，配合标准化手术室护理可减少肝脏缺血损伤，适合腹腔镜肝脏手术推广使用。

Abstract: Objective: To summarize the practical application and standardized nursing experience of self-locking hepatic portal occlusion bands made from 18Fr silicone rubber drainage tubes in laparoscopic hepatectomy. Clinical practice was adopted to optimize the procedural workflow and standardized nursing key points for hepatic portal occlusion, so as to reduce consumable costs and ischemia-related complications while ensuring surgical safety. Methods: A total of 43 patients who underwent laparoscopic hepatectomy in our hospital from January 2026 to July 2026 were enrolled. Self-made silicone rubber hepatic portal occlusion bands were used intraoperatively for all cases. Full-process nursing procedures were standardized, including band preparation, intraoperative placement and fixation, occlusion duration control, intraoperative circulatory monitoring, and postoperative consumable verification. Consumable costs and operation time were recorded, and practical nursing essentials were summarized. Results: The self-made occlusion band was easy to prepare, with a consumable cost of 3.5 yuan. The mean time for a single procedure (occlusion and release) was 1.2 minutes. No injury to the hepatic portal vessels or bile ducts, and no adverse events such as slippage, rupture of the occlusion band or residual intra-abdominal foreign bodies occurred in the 43 patients. Conclusion: The self-made silicone hepatic portal occlusion band is simple to prepare and safe to use. Combined with standardized operating room nursing, it can reduce hepatic ischemic injury, which is worthy of popularization in laparoscopic liver surgery.