目的探讨无水酒精涮洗清除手术器械携带肿瘤细胞的效果。方法选择60例行肝脏切除手术的原发性肝癌患者,将肿瘤切除阶段使用的手术器械随机均分为两组,分别置于无水酒精(实验组)和生理盐水(对照组)涮洗10s后再分别放入生理盐水中进行2次涮洗。两次涮洗后均用液基薄层细胞学检查(TCT)检测涮洗后器械上残留肿瘤细胞数目,并计算肿瘤细胞阳性率。结果第1次涮洗后,实验组肿瘤细胞数和阳性率均低于对照组[(0.12±0.09)个vs.(3.05±1.40)个和4.67%vs.63.33%](P〈0.01)。第2次涮洗后,实验组阳性率仅为1.67%,显著低于对照组的26.67%(P〈0.01)。结论肝癌手术中,无水酒精涮洗能快速有效灭活手术器械上的肿瘤细胞。
Objective To investigate the effectiveness of absolute alcohol in inactivating the exfoliated tumor cells attached on the surgical instruments during operation.Methods The instruments used in 60 cases undergiong operation for primary liver cancer were equally randomized into two groups.The instruments in group A were cleaned with absolute alcohol and those in group B were cleaned with normal saline at first time,which were repeated for the second time of cleaning in normal saline in both groups.The number of tumor cells adhered to the instruments was detected by TCT and the positive rate of tumor cells was calculated.Results The number and the positive rate of tumor cells after cleaned once were lower in group A than those in group B [(0.12±0.09) cells vs.(3.05±1.40) cells vs.and 4.67% vs.63.33%](P0.01).The positive rate of tumor cells after cleaned twice was significantly lower in group A than that in group B(1.67% vs.26.67%)(P0.01).Conclusion Cleaning the instruments with absolute alcohol twice can quickly and effectively inactivating the tumor cells and preventing cancer cell dissemination during operation.