中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2014年
2期
105-107
,共3页
董瑞%杜锡林%王青%阴继凯%赵磊%李江斌%樊东%陈安%张章
董瑞%杜錫林%王青%陰繼凱%趙磊%李江斌%樊東%陳安%張章
동서%두석림%왕청%음계개%조뢰%리강빈%번동%진안%장장
高血压,门静脉%脾切除术%腹腔镜%贲门周围血管离断术
高血壓,門靜脈%脾切除術%腹腔鏡%賁門週圍血管離斷術
고혈압,문정맥%비절제술%복강경%분문주위혈관리단술
Hypertension,portal%Splenectomy%Laparoscopes%Pericardial devascularization
目的 探讨腹腔镜脾切除联合断流术治疗门静脉高压症的方法及安全性.方法 选择第四军医大学唐都医院201 1年6月至2012年12月开展的腹腔镜脾切除联合贲门周围血管离断术与传统开腹手术患者的临床资料,其中腹腔镜组115例,开腹手术组50例,比较两组患者手术安全性及围手术期疗效.结果 腹腔镜组手术时间[(196 ±24) min]与开腹组手术时间[(160±34) min]相比差异无统计学意义(t=0.475,P=0.492).腹腔镜组术中出血量[(346±112) ml]、术后发热时间[(3.8±2.0) d]均少于开腹组[(506±167) ml、(6.6±2.7)d](t=7.449、5.806,P =0.007、0.017).腹腔镜组术后腹腔引流管拔出时间[(4.1±0.7)d]及术后住院时间[(6.3±0.6)d]均短于开腹组[(6.3±0.6)d、(8.4±0.8)d](=7.456、5.371,P=0.007、0.022).腹腔镜组手术后并发症发生率(4.5％)较开腹组(16.0％)低(P =0.025).结论 腹腔镜脾切除联合贲门周围血管离断术治疗门静脉高压症具有创伤小、出血少、术后恢复快等优点.
目的 探討腹腔鏡脾切除聯閤斷流術治療門靜脈高壓癥的方法及安全性.方法 選擇第四軍醫大學唐都醫院201 1年6月至2012年12月開展的腹腔鏡脾切除聯閤賁門週圍血管離斷術與傳統開腹手術患者的臨床資料,其中腹腔鏡組115例,開腹手術組50例,比較兩組患者手術安全性及圍手術期療效.結果 腹腔鏡組手術時間[(196 ±24) min]與開腹組手術時間[(160±34) min]相比差異無統計學意義(t=0.475,P=0.492).腹腔鏡組術中齣血量[(346±112) ml]、術後髮熱時間[(3.8±2.0) d]均少于開腹組[(506±167) ml、(6.6±2.7)d](t=7.449、5.806,P =0.007、0.017).腹腔鏡組術後腹腔引流管拔齣時間[(4.1±0.7)d]及術後住院時間[(6.3±0.6)d]均短于開腹組[(6.3±0.6)d、(8.4±0.8)d](=7.456、5.371,P=0.007、0.022).腹腔鏡組手術後併髮癥髮生率(4.5％)較開腹組(16.0％)低(P =0.025).結論 腹腔鏡脾切除聯閤賁門週圍血管離斷術治療門靜脈高壓癥具有創傷小、齣血少、術後恢複快等優點.
목적 탐토복강경비절제연합단류술치료문정맥고압증적방법급안전성.방법 선택제사군의대학당도의원201 1년6월지2012년12월개전적복강경비절제연합분문주위혈관리단술여전통개복수술환자적림상자료,기중복강경조115례,개복수술조50례,비교량조환자수술안전성급위수술기료효.결과 복강경조수술시간[(196 ±24) min]여개복조수술시간[(160±34) min]상비차이무통계학의의(t=0.475,P=0.492).복강경조술중출혈량[(346±112) ml]、술후발열시간[(3.8±2.0) d]균소우개복조[(506±167) ml、(6.6±2.7)d](t=7.449、5.806,P =0.007、0.017).복강경조술후복강인류관발출시간[(4.1±0.7)d]급술후주원시간[(6.3±0.6)d]균단우개복조[(6.3±0.6)d、(8.4±0.8)d](=7.456、5.371,P=0.007、0.022).복강경조수술후병발증발생솔(4.5％)교개복조(16.0％)저(P =0.025).결론 복강경비절제연합분문주위혈관리단술치료문정맥고압증구유창상소、출혈소、술후회복쾌등우점.
Objective To evaluate clinical efficacy of laparoscopic splenectomy plus pericardial devascularization for portal hypertension.Methods The clinical data of laparoscopic operation and open operation between June.2011 and Dec.2012 were analyzed.115 patients of portal hypertension underwent laparoscopic splenectomy combined with pericardial devascularization and 50 patients underwent traditional open operation.We compare the safety and clinical results of the two procedures.Results The operation time in laparoscopy group,(196 ± 24) min,was longer than that of the traditional open operation group,(160 ± 34) min,(t =0.475,P =0.492).The mean blood loss,fever duration after operation were (346 ± 112) ml,and (3.8 ± 2.0) d,which were less than that of the traditional group(t =7.449,5.806,P =0.007,0.017).The mean time of intraperitoneal dranage and postoperative hospital stay were (4.1 ± 0.7) d and (6.3 ± 0.6) d respectively,which were shorter than that of the traditional group (t =7.456,5.371,P =0.007,0.022).The postoperative complications of the laparoscopy group(4.5％) is lower than that (16.0％) of the traditional group (P =0.025).Conclusions Laparoscopic splenectomy combined with pericardial devascularization for portal hypertension is a safe procedure,reducing the operation trauma and blood loss,improving postoperative recovery.
