中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2014年
1期
5-8
,共4页
蒋国庆%钱建军%陈平%姚捷%陶永忠%金圣杰%王小东%高志慧%柏斗胜
蔣國慶%錢建軍%陳平%姚捷%陶永忠%金聖傑%王小東%高誌慧%柏鬥勝
장국경%전건군%진평%요첩%도영충%금골걸%왕소동%고지혜%백두성
高血压,门静脉%手术后并发症%脾切除术%腹腔镜
高血壓,門靜脈%手術後併髮癥%脾切除術%腹腔鏡
고혈압,문정맥%수술후병발증%비절제술%복강경
Hypertension,portal%Postoperative complications%Splenectomy%Laparoscopes
目的 探讨改良的腹腔镜下脾切除加贲门周围血管离断术治疗肝硬化合并门静脉高压性上消化道出血及脾亢患者的并发症防治及其临床价值.方法 回顾性分析扬州大学临床医学院2010年1月至2013年3月同期分别接受改良的腹腔镜下脾切除加贲门周围血管离断术(腹腔镜组)及开腹脾切除加贲门周围血管离断术(开腹组)的110例肝硬化性门静脉高压患者的临床资料,其中腹腔镜组39例,开腹组71例,将两组的手术情况、术后恢复情况和并发症进行比较.结果 腹腔镜组的手术时间为(221±60)min,明显长于开腹组的手术时间(175±34) min(t=4.408,P＜0.01);腹腔镜组术中失血量为(190±167) ml,显著少于开腹组的(327±244) ml(t=-3.471,P＜0.01);腹腔镜组术后住院天数为(10.4±2.2)d,显著少于开腹组的(15.8±4.3)d(t=-8.729,P＜0.01).腹腔镜组的术后并发症1例,开腹组的术后并发症17例(x2=8.407,P ＜0.01).结论 改良的腹腔镜下脾切除加贲门周围血管离断术是安全可行的,患者创伤小、并发症少、术后恢复快.
目的 探討改良的腹腔鏡下脾切除加賁門週圍血管離斷術治療肝硬化閤併門靜脈高壓性上消化道齣血及脾亢患者的併髮癥防治及其臨床價值.方法 迴顧性分析颺州大學臨床醫學院2010年1月至2013年3月同期分彆接受改良的腹腔鏡下脾切除加賁門週圍血管離斷術(腹腔鏡組)及開腹脾切除加賁門週圍血管離斷術(開腹組)的110例肝硬化性門靜脈高壓患者的臨床資料,其中腹腔鏡組39例,開腹組71例,將兩組的手術情況、術後恢複情況和併髮癥進行比較.結果 腹腔鏡組的手術時間為(221±60)min,明顯長于開腹組的手術時間(175±34) min(t=4.408,P＜0.01);腹腔鏡組術中失血量為(190±167) ml,顯著少于開腹組的(327±244) ml(t=-3.471,P＜0.01);腹腔鏡組術後住院天數為(10.4±2.2)d,顯著少于開腹組的(15.8±4.3)d(t=-8.729,P＜0.01).腹腔鏡組的術後併髮癥1例,開腹組的術後併髮癥17例(x2=8.407,P ＜0.01).結論 改良的腹腔鏡下脾切除加賁門週圍血管離斷術是安全可行的,患者創傷小、併髮癥少、術後恢複快.
목적 탐토개량적복강경하비절제가분문주위혈관리단술치료간경화합병문정맥고압성상소화도출혈급비항환자적병발증방치급기림상개치.방법 회고성분석양주대학림상의학원2010년1월지2013년3월동기분별접수개량적복강경하비절제가분문주위혈관리단술(복강경조)급개복비절제가분문주위혈관리단술(개복조)적110례간경화성문정맥고압환자적림상자료,기중복강경조39례,개복조71례,장량조적수술정황、술후회복정황화병발증진행비교.결과 복강경조적수술시간위(221±60)min,명현장우개복조적수술시간(175±34) min(t=4.408,P＜0.01);복강경조술중실혈량위(190±167) ml,현저소우개복조적(327±244) ml(t=-3.471,P＜0.01);복강경조술후주원천수위(10.4±2.2)d,현저소우개복조적(15.8±4.3)d(t=-8.729,P＜0.01).복강경조적술후병발증1례,개복조적술후병발증17례(x2=8.407,P ＜0.01).결론 개량적복강경하비절제가분문주위혈관리단술시안전가행적,환자창상소、병발증소、술후회복쾌.
Objective To explore the prevention and treatment for the complications of modified laparoscopic splenectomy and pericardial devascularization for cirrhotic patients with bleeding portal hypertension and secondary hypersplenism.Methods A total of 110 cirrhotic patients with bleeding portal hypertension and secondary hypersplenism undergoing modified laparoscopic splenectomy and pericardial devascularization or open procedures between January 2011 and March 2013 were retrospectively reviewed and analyzed.Patients were divided into laparoscopic group (LAP,n =39) and open group (OPEN,n =71).Operative time,blood loss,postoperative hospital stay and complications were compared between the two groups.Results Compared to that in open group,operative time in the LAP group was longer [(221 ± 60) min vs.(175 ± 34) min,t =4.408,P ＜ 0.01],blood loss was less [(190 ± 167) ml vs.(327 ± 244) ml,t =-3.471,P ＜0.01],postoperative hospital stay shorter [(10.4 ±2.2) d vs.(15.8 ±4.3) d,t=-8.729,P ＜ 0.01],and complications less (1 case vs.17 cases,x2 =8.407,P ＜ 0.01).Conclusions Modified laparoscopic splenectomy and pericardial devascularization for cirrhotic patients with bleeding portal hypertension and secondary hypersplenism is safe.Complications are less,and recovery are faster.
