[1]黄 明.腹腔镜脾切除术对创伤性脾破裂患者门静脉血栓形成及血清YKL-40的影响[J].医学信息,2022,35(12):134-137.[doi:10.3969/j.issn.1006-1959.2022.12.032]
　HUANG Ming.Effect of Laparoscopic Splenectomy on Portal Vein Thrombosis and Serum YKL-40 in Patients with Traumatic Splenic Rupture[J].Medical Information,2022,35(12):134-137.[doi:10.3969/j.issn.1006-1959.2022.12.032]
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腹腔镜脾切除术对创伤性脾破裂患者门静脉血栓形成及血清YKL-40的影响()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年12期
页码:
134-137
栏目:
论著
出版日期:
2022-06-15

文章信息/Info

Title:
Effect of Laparoscopic Splenectomy on Portal Vein Thrombosis and Serum YKL-40 in Patients with Traumatic Splenic Rupture
文章编号:
1006-1959（2022）12-0134-04
作者:
黄 明
（南昌大学第一附属医院高新医院急诊科，江西 南昌 330000）
Author(s):
HUANG Ming
(Department of Emergency,Gaoxin Hospital of the First Affiliated Hospital of Nanchang University,Nanchang 330000,Jiangxi,China)
关键词:
创伤性脾破裂; 腹腔镜脾切除术; 门静脉血栓形成; 脾动脉; 免疫功能
Keywords:
Traumatic splenic rupture; Laparoscopic splenectomy; Portal vein thrombosis; Spleen artery; Immune function
分类号:
R657.6
DOI:
10.3969/j.issn.1006-1959.2022.12.032
文献标志码:
A
摘要:
目的 研究腹腔镜脾切除术治疗创伤性脾破裂患者的效果及对门静脉血栓形成和血清YKL-40的影响。方法 选取南昌大学第一附属医院高新医院2019年1月-2021年1月收治的83例创伤性脾破裂患者为研究对象，根据患者手术方式分为对照组（47例）与研究组（36例）。对照组采用传统开腹手术，研究组行术腹腔镜脾切除术，比较两组手术相关指标、免疫功能、并发症发生率、血小板计数、门静脉血栓发生率及血清YKL-40水平。结果 研究组手术时间、脾动脉结扎时间、术中出血量、发热时间、住院时间、术后肛门排气时间、术后镇痛药物使用率、术后引流量均低于对照组，自体血使用量高于对照组，差异有统计学意义（P＜0.05）；两组术后2周血液IgG、IgM、IgA水平均高于术前，且研究组高于对照组，差异有统计学意义（P＜0.05）；对照组并发症发生率为17.02%，高于研究组的8.33%，差异有统计学意义（P＜0.05）；两组术后各时间点血小板计数与术前比较，差异有统计学意义（P＜0.05）；术后7、14、21和30 d对照组血小板计数均高于研究组，差异有统计学意义（P＜0.05）；术后30 d对照组门静脉血栓发生率为17.21%，高于研究组的5.56%，差异有统计学意义（P＜0.05）；术后2周两组血清YKL-40水平均降低，且研究组低于对照组，差异有统计学意义（P＜0.05）。结论 腹腔镜脾切除术治疗创伤性脾破裂疗效确切且安全性更好，还可减少门静脉血栓形成，降低血清YKL-40水平；临床可结合脾破裂程度及有无其他损伤等情况优先选择腹腔镜手术。
Abstract:
Objective To study the effect of laparoscopic splenectomy in the treatment of traumatic splenic rupture and its effect on portal vein thrombosis and serum YKL-40.Methods A total of 83 patients with traumatic splenic rupture admitted to the Gaoxin Hospital of the First Affiliated Hospital of Nanchang University from January 2019 to January 2021 were selected as the research objects, and they were divided into the control group (47 cases) and the study group (36 cases) according to the surgical methods. The control group was treated with traditional open surgery, and the study group was treated with laparoscopic splenectomy. The operation-related indicators, immune function, incidence of complications, platelet count, incidence of portal vein thrombosis and serum YKL-40 levels of the two groups were compared.Results The operation time, splenic artery ligation time, intraoperative blood loss, fever time, hospitalization time, postoperative anal exhaust time, postoperative analgesic drug use rate and postoperative drainage in the study group were lower than those in the control group, and the use of autologous blood was higher than that in the control group, the difference was statistically significant (P<0.05). The levels of serum IgG, IgM and IgA in the two groups at 2 weeks after operation were higher than those before operation, and those in the study group were higher than those in the control group, with statistically significant differences (P<0.05). The incidence of complications in the control group was 17.02%, which was higher than 8.33% in the study group, and the difference was statistically significant (P<0.05). The platelet count at each time point after operation in the two groups was compared with that before operation, and the difference was statistically significant (P<0.05). The platelet count in the control group at 7, 14, 21 and 30 d after operation was higher than that in the study group, and the difference was statistically significant (P<0.05). At 30 d after operation, the incidence of portal vein thrombosis in the control group was 17.21%, which was higher than 5.56% in the study group, and the difference was statistically significant (P<0.05). At 2 weeks after operation, the serum YKL-40 levels in the two groups were decreased, and the study group was lower than the control group, the difference was statistically significant (P<0.05).Conclusion Laparoscopic splenectomy is effective and safe in the treatment of traumatic splenic rupture, which can also reduce portal vein thrombosis and reduce serum YKL-40 level. Meanwhile laparoscopic surgery can be preferred according to the degree of splenic rupture and other injuries.

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更新日期/Last Update: 1900-01-01