[1]王翔翔,刘明忠,杨中秋,等.腹腔镜与开腹脾切除贲门周围血管离断术治疗肝硬化门静脉高压脾肿大的临床对比[J].医学信息,2019,32(01):109-111.[doi:10.3969/j.issn.1006-1959.2019.01.033]
　WANG Xiang-xiang,LIU Ming-zhong,YANG Zhong-qiu,et al.Clinical Comparison of Laparoscopic and Open Spleen Resection of the Pericardium in the Treatment of Cirrhosis with Portal Hypertension and Splenomegaly[J].Journal of Medical Information,2019,32(01):109-111.[doi:10.3969/j.issn.1006-1959.2019.01.033]
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腹腔镜与开腹脾切除贲门周围血管离断术治疗肝硬化门静脉高压脾肿大的临床对比()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
32卷
期数:
2019年01期
页码:
109-111
栏目:
临床研究
出版日期:
2019-01-01

文章信息/Info

Title:
Clinical Comparison of Laparoscopic and Open Spleen Resection of the Pericardium in the Treatment of Cirrhosis with Portal Hypertension and Splenomegaly
文章编号:
1006-1959（2019）01-0109-03
作者:
王翔翔; 刘明忠; 杨中秋; 张兴雕; 刘 洪
达州市中心医院肝胆外科，四川 达州 635000
Author(s):
WANG Xiang-xiang; LIU Ming-zhong; YANG Zhong-qiu; ZHANG Xing-diao; LIU Hong
Department of Hepatobiliary Surgery,Dazhou Central Hospital,Dazhou635000,Sichuan,China
关键词:
腹腔镜; 脾切除术; 断流术; 门静脉高压
Keywords:
Laparoscopy; Splenectomy; Devascularization; Portal hypertension
分类号:
R657.34
DOI:
10.3969/j.issn.1006-1959.2019.01.033
文献标志码:
A
摘要:
目的 比较腹腔镜和开腹脾切除断流术治疗肝硬化门脉高压症的近期临床效果。方法 选取我院2016年1月~2017年12月肝硬化门脉高压患者57例，随机分为腹腔镜组和开腹组。腹腔镜组30例采用腹腔镜脾切除断流术治疗，开腹组27例采用开腹脾切除断流术治疗。对比两组患者的手术时间、术中出血量、引流量、排气时间、术后肝功能分级、术后并发症发生率、住院时间和住院总费用。结果 腹腔镜组的手术时间长于开腹组［（187.56±27.43）min vs（153.82±45.19）min］，腹腔镜组术中出血量［（320.85±158.65）ml vs（430.25±202.16）ml］、术后腹腔引流量［（780.65±235.43）ml vs（1225.45±189.35）ml］和住院时间［（7.55±3.25）d vs（10.57±4.37）d］均低于开腹组，腹腔镜组术后并发症发生率低于开腹组（16.67% vs 25.93%），差异均有统计学意义（P＜0.05）。两组患者术后肝功能分级和住院总费用相比，差异无统计学意义（P＞0.05）。结论 腹腔镜脾切除断流术安全可行，其近期临床效果较传统开腹手术具有恢复快、并发症少等优势，具有微创手术的优越性。
Abstract:
Objective To compare the recent clinical effects of laparoscopic splenectomy and disconnection in the treatment of cirrhotic portal hypertension. Methods 57 patients with portal hypertension from January 2016 to December 2017 were randomly divided into laparoscopic group and open group. Laparoscopic splenectomy and disconnection were performed in 30 cases in laparoscopic group and 27 cases in laparotomy group. The operative time, intraoperative blood loss, drainage flow, exhaust time, postoperative liver function grading, postoperative complications, hospital stay and total hospitalization cost were compared between the two groups. Results The operation time of the laparoscopic group was longer than that of the open group [(187.56±27.43) min vs (153.82±45.19) min], and the amount of bleeding in the laparoscopic group [(320.85±158.65) ml vs (430.25±202.16) ml], surgery Posterior abdominal drainage [(780.65±235.43) ml vs (1225.45±189.35) ml] and hospitalization time [(7.55±3.25) d vs (10.57±4.37) d] were lower than the open group, and the laparoscopic group was concurrent The incidence of symptoms was lower than that of the open group (16.67% vs 25.93%),the difference was statistically significant (P<0.05). There was no significant difference in postoperative liver function grading and total hospitalization cost between the two groups (P>0.05). Conclusion Laparoscopic splenectomy is safe and feasible. Its recent clinical effect has the advantages of faster recovery and less complications than traditional open surgery. It has the superiority of minimally invasive surgery.

参考文献/References:

[1]吴志勇,陈炜.肝硬化门静脉高压症围术期处理策略[J].中华消化外科杂志,2016,15(7):661-664.
[2]Zheng X,Liu Q,Yao Y.Laparoscopic splenectomy and esophagogastric devascularization is a safe,effective,minimally invasive alternative for the treatment of portal hypertension with refractory variceal bleeding[J].Surg Innov,2013,20(1):32-39.
[3]俞海波.手辅助腹腔镜与完全腹腔镜脾切除加门奇断流术的临床对比分析[J].中华肝胆外科杂志,2013,10(2):72-75.
[4]Jankulovski N,Antovic S,Petrusevska G,et al.Laparoscopic versus open splenectomy: a single center eleven-year experience[J].Acta Clinica Croatica,2013,52(2):229-234.
[5]贺新新,罗汉传,陈培升,等.腹腔镜脾切除联合贲门周围血管离断术在门静脉高压症中的应用[J].中国普外基础与临床杂志,2013,20(7):772-775.
[6]许焕建,孙学征,傅宏,等.腹腔镜下二级脾蒂离断法脾切除术中出血的预防[J].中国内镜杂志,2014,20(4):443-445.
[7]刘勇峰,梅乐园,袁江涛,等.全腹腔镜下脾切除联合贲门周围血管离断术19例体会[J].肝胆胰外科杂志,2013,25(2):141-142.
[8]潘孟,赫军,蔡小勇,等.完全腹腔镜与开腹改良Sugiura手术治疗门静脉高压症的临床对比研究[J].中华外科杂志,2013,51(8):746-747.
[9]帅晓明,陈俊华,韩高雄,等.改良手助腹腔镜和完全腹腔镜下脾切除加贲门周围血管离断术的比较研究 [J].中华肝胆外科杂志,2013,19(1):36-40.
[10]Wu Z,Zhou J,Pankaj P,et al.Laparoscopic and open splenectomy for splenomegaly secondary to liver cirrhosis：an evaluation of immunity[J].Surg Endosc,2012,26(12):3557-3564.
[11]陈志玉,戴朝六.门静脉高压症脾功能亢进的外科治疗[J].中国普外基础与临床杂志,2015,22(7):884-887.
[12]Zhou J,Wu Z,Pankaj P,et al.Long-term postoperative outcomes of hypersplenism：laparoscopic versus open splenectomy secondary to liver cirrhosis[J].Surg Endosc,2012,26(12):3391-3400.
[13]田浪,胡勇,冯燮林.腹腔镜脾切除与开腹脾切除治疗肝硬变门静脉高压致脾功能亢进疗效比较的系统评价[J].中国普外基础与临床杂志,2013,20(3):293-301.
[14]黄俊明,袁超杰,伍宏章,等.完全腹腔镜下脾切除加选择性贲门血管离断术与开腹手术对比研究[J].临床医学工程,2012,19(8):1341-1342.
[15]Somasundaram SK,Massey L,Gooch D,et al.Laparoscopic splenectomy is emerging gold standard treatment even for massive spleens[J].Ann R Coll Surg Eng,2015,97(5):1-4.
[16]Odabasi M,Abuoglu HH,Arslan C,et al.Asymptomatic partial splenic infarction in laparoscopic floppy Nissen fundoplication and brief literature review[J].Int Surg,2014,99(3):291-294.

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更新日期/Last Update: 2019-01-22