中国医学前沿杂志（电子版）
中國醫學前沿雜誌（電子版）
중국의학전연잡지（전자판）
CHINESE JOURNAL OF THE FRONTIERS OF MEDICAL SCIENCE(ELECTRONIC VERSION)
2014年
12期
67-69
,共3页
脾大%腹腔镜%脾切除术
脾大%腹腔鏡%脾切除術
비대%복강경%비절제술
Splenomegaly%Laparoscopy%Splenectomy
目的：探讨经腹腔镜脾切除术治疗重度以上脾大的临床疗效及安全性。方法选取2012年8月至2014年8月于本院行脾切除治疗的重度以上脾大患者84例，按照随机数表法将其分为对照组和观察组，每组各42例。对照组患者行传统开腹脾切除术，观察组患者行腹腔镜脾切除术，比较两组患者术中情况及术后并发症发生率。结果观察组患者脾质量为（1152.4±241.9）g，脾上下级长度为（23.5±4.2）cm，手术时间为（179.8±44.2）分钟，术中出血量为（202.7±55.6）ml，术中输血率为16.7%（7/42），术后住院时间为（7.2±1.9）天，无再手术及死亡病例，中转开腹3例。对照组患者脾质量为（1161.2±236.7）g，脾上下级长度为（22.9±4.5）cm，手术时间为（152.4±24.7）分钟，术中出血量为（398.6±81.9）ml，术中输血率为45.2%（19/42），术后住院时间为（10.4±2.2）天，再手术6例（14.3%），无死亡病例。观察组患者手术时间长于对照组，术中出血量、术中输血率及住院时间少于对照组，差异均具有显著性（P＜0.05）。观察组患者术后并发症发生率为11.9%（5/42），对照组为33.3%（14/42），组间比较差异具有显著性（P＜0.05）。结论经腹腔镜脾切除术治疗重度以上脾大安全可行，预后较好，值得临床推广应用。
目的：探討經腹腔鏡脾切除術治療重度以上脾大的臨床療效及安全性。方法選取2012年8月至2014年8月于本院行脾切除治療的重度以上脾大患者84例，按照隨機數錶法將其分為對照組和觀察組，每組各42例。對照組患者行傳統開腹脾切除術，觀察組患者行腹腔鏡脾切除術，比較兩組患者術中情況及術後併髮癥髮生率。結果觀察組患者脾質量為（1152.4±241.9）g，脾上下級長度為（23.5±4.2）cm，手術時間為（179.8±44.2）分鐘，術中齣血量為（202.7±55.6）ml，術中輸血率為16.7%（7/42），術後住院時間為（7.2±1.9）天，無再手術及死亡病例，中轉開腹3例。對照組患者脾質量為（1161.2±236.7）g，脾上下級長度為（22.9±4.5）cm，手術時間為（152.4±24.7）分鐘，術中齣血量為（398.6±81.9）ml，術中輸血率為45.2%（19/42），術後住院時間為（10.4±2.2）天，再手術6例（14.3%），無死亡病例。觀察組患者手術時間長于對照組，術中齣血量、術中輸血率及住院時間少于對照組，差異均具有顯著性（P＜0.05）。觀察組患者術後併髮癥髮生率為11.9%（5/42），對照組為33.3%（14/42），組間比較差異具有顯著性（P＜0.05）。結論經腹腔鏡脾切除術治療重度以上脾大安全可行，預後較好，值得臨床推廣應用。
목적：탐토경복강경비절제술치료중도이상비대적림상료효급안전성。방법선취2012년8월지2014년8월우본원행비절제치료적중도이상비대환자84례，안조수궤수표법장기분위대조조화관찰조，매조각42례。대조조환자행전통개복비절제술，관찰조환자행복강경비절제술，비교량조환자술중정황급술후병발증발생솔。결과관찰조환자비질량위（1152.4±241.9）g，비상하급장도위（23.5±4.2）cm，수술시간위（179.8±44.2）분종，술중출혈량위（202.7±55.6）ml，술중수혈솔위16.7%（7/42），술후주원시간위（7.2±1.9）천，무재수술급사망병례，중전개복3례。대조조환자비질량위（1161.2±236.7）g，비상하급장도위（22.9±4.5）cm，수술시간위（152.4±24.7）분종，술중출혈량위（398.6±81.9）ml，술중수혈솔위45.2%（19/42），술후주원시간위（10.4±2.2）천，재수술6례（14.3%），무사망병례。관찰조환자수술시간장우대조조，술중출혈량、술중수혈솔급주원시간소우대조조，차이균구유현저성（P＜0.05）。관찰조환자술후병발증발생솔위11.9%（5/42），대조조위33.3%（14/42），조간비교차이구유현저성（P＜0.05）。결론경복강경비절제술치료중도이상비대안전가행，예후교호，치득림상추엄응용。
Objective To explore the laparoscopic splenectomy in the treatment of severe splenomegaly than clinical efifcacy and safety. Method From August 2012 to August 2014 in our hospital for splenectomy in the treatment of severe splenomegaly in 84 patients, according to the random number table method which were divided into observation group and control group, 42 cases in each group. Patients in control group underwent conventional open splenectomy, laparoscopic splenectomy patients in observation group, and the incidence of postoperative complications were compared between the two groups. Result Observation group spleen quality was (1152.4±241.9) g, the spleen on the lower length was (23.5±4.2) cm, operation time was (179.8±44.2) minutes, bleeding was (202.7±55.6) ml, intraoperative blood transfusion rate was 16.7% (7/42), the postoperative hospital stay was (7.2±1.9) days, no operation and death cases, 3 cases were converted to open operation. Patients in control group the spleen quality was (1161.2±236.7) g, the spleen on the lower length was (22.9±4.5) cm, operation time was (152.4±24.7) minutes, bleeding was (398.6±81.9) ml, intraoperative blood transfusion rate was 45.24% (19/42), the postoperative hospital stay was (10.4±2.2) days, then the operation in 6 cases (14.3%), no death case. Patients in observation group operation time was longer than control group, the bleeding rate and hospitalization time was shorter than that of control group, the volume of blood transfusion during operation, the difference was signiifcant (P<0.05). Patients in observation group the incidence of postoperative complications was 11.9%(5/42), the control group was 33.3%(14/42), the differences was signiifcant (P<0.05). Conclusion Laparoscopic splenectomy for treatment of severe splenomegaly more safe and feasible, the prognosis is good, with a clinical application value.
