CAJ | 학술논문

目的探讨腹腔镜脾切除术治疗肝硬化门静脉高压症脾功能亢进的适应证、手术技巧及临床应用价值.方法对比分析吉林大学第一医院32例门静脉高压症脾功能亢进病人行腹腔镜脾切除术及开腹脾切除术的方法体会及治疗效果.结果腹腔镜脾切除组16例手术14例获得成功,2例中转开腹;开腹脾切除组16例手术均获成功,两组病人在手术时间、术中出血量、医疗费用上差别无显著意义;腹腔镜组平均住院日5.50 d,进食时间为术后20.50 h,拔出引流管时间为1.65 d,与开腹组的8.50 d、68.00 h、5.26 d相比,具有明显优势(P＜0.01).结论与传统的开腹脾切除手术相比,腹腔镜脾切除术具有微创外科创伤小、恢复快的优点,掌握好手术适应证,选择轻中度静脉曲张的肝硬化门静脉高压症脾功能亢进者行LS是安全可行的,但必须有充分的术前准备、良好的腹腔镜手术训练、细致的手术操作.
목적 탐토복강경비절제술치료간경화문정맥고압증비공능항진적괄응증、수술기교급림상응용개치.방법 대비분석길림대학제일의원32례문정맥고압증비공능항진병인행복강경비절제술급개복비절제술적방법체회급치료효과.결과 복강경비절제조16례수술14례획득성공,2례중전개복;개복비절제조16례수술균획성공,량조병인재수술시간、술중출혈량、의료비용상차별무현저의의;복강경조평균주원일5.50 d,진식시간위술후20.50 h,발출인류관시간위1.65 d,여개복조적8.50 d、68.00 h、5.26 d상비,구유명현우세(P＜0.01).결론 여전통적개복비절제수술상비,복강경비절제술구유미창외과창상소、회복쾌적우점,장악호수술괄응증,선택경중도정맥곡장적간경화문정맥고압증비공능항진자행LS시안전가행적,단필수유충분적술전준비、량호적복강경수술훈련、세치적수술조작.
Objective To explore the indications,surgical techniques and clinical effects of laparoscopic splenectomy on patients with portal hypertension. Methods Analysis the clinical data of 32 patients of portal hypertenision with laparoscopic splenectomy and open splenectomy from March 2006 until June 2009. Results The effectiveness of the procedures for portal hypertension was evaluated.Among 16 patients with LS, 2 patients were converted to open surgery. There is no significant difference with operatative time, blood loss and hospital fees between the two groups, the laparoscpy group had the shorter mean hospitalization, fasting and draining time. Conclusions If there are enough preparation preoperation, skillful laparoscopic technique and micromesh manipulation during operation,laparoscopic splenectomy is a minimally invasive and safe technique in the patients with lower-grade to medium varicose veins.