中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2013年
3期
208-210
,共3页
原春辉%裴琛%贾易木%熊京伟%修典荣
原春輝%裴琛%賈易木%熊京偉%脩典榮
원춘휘%배침%가역목%웅경위%수전영
脾肿瘤%血液病%腹腔镜检查%脾切除术
脾腫瘤%血液病%腹腔鏡檢查%脾切除術
비종류%혈액병%복강경검사%비절제술
Splenic neoplasms%Hematologic diseases%Laparoscopy%Splenectomy
目的 总结腹腔镜脾切除术的经验和探讨其临床应用价值.方法 回顾性分析自1995年开展腹腔镜脾切除术以来所有脾切除术患者的临床资料.将63位患者的相关资料分为6组,比较它们的手术时间、手术中出血量、术后住院天数、术后开始流食天数、术后引流管拔出天数、术后4d内引流量、手术后并发症和手术适应证.结果 63例患者的平均年龄为44.19岁,身体质量指数平均为23.75；中转开腹3例,2003年后开展的53例在患者手术时间、手术中出血量、术后住院天数、术后开始流食天数、手术后并发症、中转开腹率等方面好于2003年前开展的10例.2003年前手术适应证限于与脾脏相关性血液系统疾病,2003年后适应证范围明显扩大,以治疗脾脏肿瘤为主.结论 腹腔镜脾切除手术存在明显的学习曲线变化趋势,经历10例手术后进入并一直保持在手术平台期.在严格掌握适应证下,腹腔镜脾切除术是安全、有效、可行的,腹腔镜脾切除不仅适用于脾脏相关性血液系统疾病,也适用于脾脏肿瘤性疾病.
目的 總結腹腔鏡脾切除術的經驗和探討其臨床應用價值.方法 迴顧性分析自1995年開展腹腔鏡脾切除術以來所有脾切除術患者的臨床資料.將63位患者的相關資料分為6組,比較它們的手術時間、手術中齣血量、術後住院天數、術後開始流食天數、術後引流管拔齣天數、術後4d內引流量、手術後併髮癥和手術適應證.結果 63例患者的平均年齡為44.19歲,身體質量指數平均為23.75；中轉開腹3例,2003年後開展的53例在患者手術時間、手術中齣血量、術後住院天數、術後開始流食天數、手術後併髮癥、中轉開腹率等方麵好于2003年前開展的10例.2003年前手術適應證限于與脾髒相關性血液繫統疾病,2003年後適應證範圍明顯擴大,以治療脾髒腫瘤為主.結論 腹腔鏡脾切除手術存在明顯的學習麯線變化趨勢,經歷10例手術後進入併一直保持在手術平檯期.在嚴格掌握適應證下,腹腔鏡脾切除術是安全、有效、可行的,腹腔鏡脾切除不僅適用于脾髒相關性血液繫統疾病,也適用于脾髒腫瘤性疾病.
목적 총결복강경비절제술적경험화탐토기림상응용개치.방법 회고성분석자1995년개전복강경비절제술이래소유비절제술환자적림상자료.장63위환자적상관자료분위6조,비교타문적수술시간、수술중출혈량、술후주원천수、술후개시류식천수、술후인류관발출천수、술후4d내인류량、수술후병발증화수술괄응증.결과 63례환자적평균년령위44.19세,신체질량지수평균위23.75；중전개복3례,2003년후개전적53례재환자수술시간、수술중출혈량、술후주원천수、술후개시류식천수、수술후병발증、중전개복솔등방면호우2003년전개전적10례.2003년전수술괄응증한우여비장상관성혈액계통질병,2003년후괄응증범위명현확대,이치료비장종류위주.결론 복강경비절제수술존재명현적학습곡선변화추세,경력10례수술후진입병일직보지재수술평태기.재엄격장악괄응증하,복강경비절제술시안전、유효、가행적,복강경비절제불부괄용우비장상관성혈액계통질병,야괄용우비장종류성질병.
Objective To explore the clinical application of laparoscopic splenectomy in treatment of spleen disease at our hospital.Methods We reviewed laparoscopic splenectomy carried out at our hospital since 1995,patients were grouped by date.63 laparoscopic splenectomies were divided into six groups.Operation time,intraoperative blood loss,postoperative hospital stay,time to feeding,days of drainage,amount of drainage,postoperative complications and indications for surgery were compared.Results Patient's age averaged at 44.19 years,body mass index averaged at 23.75,3 patients were converted to open surgery.Mean operating time,blood loss,postoperative hospital stay,time to feeding,converting rate in the 53 cases which had the surgery after 2003 were much better than the 10 cases before 2003.Surgical indications for laparoscopic splenectomy were limited to hematopoietic disease related splemegaly before 2003,the indication range significantly expanded after 2003,during which laparoscopic splenectomy were mainly applied to treat spleen tumors.Conclusions There is a marked learning curve in laparoscopic splenectomy after 10 surgeries before 2003 we have achieved the level.With the suitable approach,apparatus and skillful technique,laparoscopic splenectomy is safe and feasible to treat tumors of the spleen.
