经内镜食管曲张静脉套扎术联合腹腔镜脾切除术治疗门静脉高压症  

Endoscopic varicose vein ligation combined with laparoscopic splenectomy on portal hypertension

作　　者：秦明放[1] 杨慧琪[1] 王庆[1] 勾承月[1] 李宁[1] 

机构地区：[1]天津南开医院微创外科,300100

出　　处：《中华消化内镜杂志》2005年第1期37-39,共3页Chinese Journal of Digestive Endoscopy

摘　　要：目的 探讨经内镜食管曲张静脉套扎联合手助腹腔镜脾切除术治疗门静脉高压症的 疗效及安全性。方法 2001年6月至2004年10月,对15例中、重度食管静脉曲张且脾功能亢进患 者先行内镜食管曲张静脉套扎术,待食管静脉曲张消失或降为轻度后1-2周,行手助腹腔镜脾切除 术。结果 每例平均套扎治疗2.2次,套扎后11例食管静脉曲张完全消失,4例静脉曲张由重度降 为轻度。手助腹腔镜脾切除术无严重手术并发症,无中转开腹及死亡病例。术后1周复查,血小板由 术前的(38-67)×10 6／L升至(89-310)×10 6／L,平均随访17.6个月,无上消化道出血。结论 对 于门静脉高压脾功能亢进者,内镜食管曲张静脉套扎术联合手助腹腔镜脾切除术具有微创的优点,安 全、有效。Objective To study on the effectiveness and reliability of endoscopic varicose vein ligation (EVL) combined with hand-assisted laparoscopic splenectomy (HLS) in portal hypertensive patients. Methods Retrospectively 15 cases of EVL combined with HLS were reviewed from June 2001 to October 2004. These patients with severe esophageal varicose and hypersplenism were adapted to perform endoscopic varicose vein ligation, then 1 -2 weeks after the varicose became milder or disappeared, hand-assisted laparoscopic splenectomy was conducted. Results The number of preoperative ligation was 2. 2 times in average. Esophageal varicose was completely disappeared in 11 and mild in 4. There were no postoperative complications, conversion and death in Hand-assisted laparoscopic splenectomy. The average postoperative count of platelets were (38-67) × 106/L preoperatively raised to (89-310) × 106/L postoperatively. In the follow up period (average 17. 6 months) , no varicose vein bleeding happened. Conclusions EVL combined with HLS is not only minimal invasive, but also a secure and effective measure for portal hypertension.

关 键 词：经内镜食管曲张静脉套扎术 腹腔镜脾切除术 治疗 门静脉高压症 

分 类 号：R657.3[医药卫生—外科学]