CAJ | 학술논문

目的：对比应用腔镜直线型切割缝合器行开腹脾切除术与传统脾切除术的临床效果。方法回顾性分析沈阳军区总医院急诊外科2010年1月至2014年1月收治的因外伤性脾破裂行开腹脾切除手术50例患者的病历资料，将2012年1月至2014年1月应用腔镜直线型切割缝合器行脾切除术患者28例作为观察组，2010年1月至2012年1月采用传统脾切除术患者22例作为对照组，对比两组在手术时间、术后引流量、术后并发症发生率及出血量等方面的差异。结果与对照组比较，观察组手术时间明显缩短，术区引流量较少，术后再出血、脾热、胰漏等并发症发生率明显降低，差异均有统计学意义（均P<0.05）。而在出血量方面二者差异无统计学意义（P>0.05）。结论创伤性脾破裂行开腹脾切除术中应用腔镜直线型切割缝合器可快速、安全、有效地离断脾蒂血管，减少手术时间及术后并发症的发生，较传统手术方式优势显著，值得临床推广应用。
목적：대비응용강경직선형절할봉합기행개복비절제술여전통비절제술적림상효과。방법회고성분석침양군구총의원급진외과2010년1월지2014년1월수치적인외상성비파렬행개복비절제수술50례환자적병력자료，장2012년1월지2014년1월응용강경직선형절할봉합기행비절제술환자28례작위관찰조，2010년1월지2012년1월채용전통비절제술환자22례작위대조조，대비량조재수술시간、술후인류량、술후병발증발생솔급출혈량등방면적차이。결과여대조조비교，관찰조수술시간명현축단，술구인류량교소，술후재출혈、비열、이루등병발증발생솔명현강저，차이균유통계학의의（균P<0.05）。이재출혈량방면이자차이무통계학의의（P>0.05）。결론창상성비파렬행개복비절제술중응용강경직선형절할봉합기가쾌속、안전、유효지리단비체혈관，감소수술시간급술후병발증적발생，교전통수술방식우세현저，치득림상추엄응용。
Objective To compare the clinical effects between conventional splenectomy and application of endoscopic linear cutter in the open splenectomy. Methods From January 2010 to January 2014,we performed retrospective study on 50 patients who received open splenectomy due to traumatic splenic rupture in the General Hospital of Shenyang Military Region.28 cases of these patients received open splenectomy using endoscopic linear cutter(observation group),while 22 cases of them received conventional splenectomy(control group). We compared the two groups on factors including operating time, surgical drainage, complications, and introperative blood loss. Results The observation group showed significantly better result in operating time, surgical drainage and occurrence of complications such as blood loss post surgery, spleen fever, and pancreatic fistula(P<0.05).However, no significant difference has been observed in introperative blood loss (P>0.05). Conclusion Application of endoscopic linear cutter in open splenectomy on cases of traumatic splenic rupture enables resection of splenic pedical fast, safely and effectively, decreasing operating time and occurrence of complications, which has evident advantages compared with the conventional surgery and is worthy of being wider used in clinic.