腹腔镜脾切除与开腹脾切除治疗特发性血小板减少性紫癜的临床观察  

A comparative study on laparoscopic splenectomy and open splenectomy for the treatment of idiopathic thrombocytopenic purpura

作　　者：郑朝旭[1] 陈国泰[1] 吴志棉[1] 谭敏[1] 陈流华[1] 余俊峰[1] 赵振献[1] 

机构地区：[1]中山大学附属第一医院普通外科,广州510080

出　　处：《中华普通外科杂志》2005年第6期344-346,共3页Chinese Journal of General Surgery

摘　　要：目的比较腹腔镜脾切除术(laparoscopicsplenectomy,LS)和开腹脾切除术(opensplenectomy,OS)治疗特发性血小板减少性紫癜(idiopathicthrombocytopenicpurpura,ITP)的结果。方法36例进行LS,26例进行OS。率的比较采用χ2检验,均数比较采用Studentt检验。结果LS组和OS组手术时间分别为(135.3±60.5)min和(108.5±29.7)min(t=2.083,P=0.042),术中出血量分别为(110±127)ml和(185±128)ml(t=2.284,P=0.026),LS组术后疼痛显著较OS组轻微(χ2=18.158,P<0.01),术后恢复饮食快(t=2.251,P=0.028),而并发症发生率差别不显著(χ2=0.729,P>0.05)。对ITP治疗有效率LS组为92%,OS组为88%(χ2=0.177,P>0.05)。结论LS治疗ITP的疗效与OS相近,而且创伤小、恢复快、并发症发生率低。Objective To compare laparoscopic splenectomy(LS) with open splenectomy(OS) in patients with idiopathic thrombocytopenic purpura(ITP). MethodsClinical data of 36 ITP cases undergoing LS and 26 counterparts undergoing OS were analyzed retrospectively. ResultsMean operative time was (135.3±60.5) min for LS and (108.5±29.7) min for OS (t=2.083,P=0.042). Estimated intraoperative blood loss was (110±127) ml for LS and (185±128) ml for OS (t=2.284,P=0.026).Postoperative pain was significantly less in LS group (χ~2=18.158,P<0.01), and nothing per mouth period was shorter(t=2.251,P=0.028). The postoperative complications developed in 5.6% for LS and 11.5% for OS (χ~2=0.729,P>0.05). Treatment effectiveness was 92% in LS and 88% in OS (χ~2=0.177,P>0.05). Conclusions LS,whereas of less traumatic and low morbidity, results in comparable effects as OS for the treatment of ITP.

关 键 词：腹腔镜 脾切除术 开腹脾切除术 特发性血小板减少性紫癜 LS 手术方法 

分 类 号：R657.6[医药卫生—外科学]