腰交感神经节切除术手术方式的临床对比研究  

A comparative study on different lumbar gangliosympathectomies

作　　者：代远斌[1] 卢小刚[1] 

机构地区：[1]重庆医科大学附属第一医院普外科,重庆市普外科重点实验室,重庆400016

出　　处：《解放军医学杂志》2007年第5期536-537,共2页Medical Journal of Chinese People's Liberation Army

摘　　要：目的比较研究腹腔镜与开腹行腰交感神经节切除术的手术及术后并发症等情况。方法2002年6月～2006年5月,采用腹腔镜腰交感神经节切除术(VALLS)治疗Buerger’s病21例,在手术时间、出血量及术后并发症等方面与同期27例开腹手术进行对比。结果VALLS组174±14.84min,明显高于开腹组132±32.81min(P<0.05)。VALLS组出血量为70±29.2ml,明显少于开腹组117±15.7ml(P<0.05)。VALLS组术后住院时间为3.7±1.3天,明显少于开腹组7.3±1.9天(P<0.05)。两组手术术后并发症发生率无明显差异,但并发症组成并不相同。两组手术的术后效果无明显差异。结论腹腔镜腰交感神经节切除是治疗Buerger’s病的安全、有效的手术方法,手术创伤小,并发症少,术后恢复快,值得临床推广。Objective To compare the video-assisted laparoscopic lumbar gangliosympathectomy with open lumbar gangliosympathectomy on their advantages and disadvantages. Method From June 2002 to May 2006, a total of 21 adults with Buerger＇s disease underwent the video-assisted laparoscopic lumbar gangliosympathectomy. The operation time, intraoperative blood loss, hospitalization time, postoperative effects and postoperative complications were analyzed. The data of the 21 cases were compared with those from other 27 cases with Buerger＇s disease who had undergone open lumbar gangliosympathectomy in the same period. Results The operation time was longer in the laparoscopic group （174±14. 84min） than that in the open group （132±32. 81min, P〈0. 05）; The intraoperative blood loss was less in the laparoscopic group （70±29.2ml） than that in the open group （117±15.7ml, P〈0. 05） ; The hospitalization time was shorter in the laparoscopic group （3. 7±1.3d） than that in the open group （7. 3±1. 9d, P〈0. 05） ; There was no statistical difference in the postop erative complications between the two groups, but the complications emerged in the two groups were not the same There was no statistical difference in the postoperative effects between the two groups. All cases＂ postoperative effect was satisfying. Conclusions Compared with open lumbar gangliosympathectomy, the video-assisted laparoscopic lumbar gangliosympathectomy is a safe and effective operation for Buerger＇s disease with little injuries and less blood loss, and with the postoperative advantages of quick recovery. The video-assisted lapam scopic lumbar gangliosympathectomy is deserved of general introduction into clinic on the treatment for Buerger＇s disease.

关 键 词：腰交感神经节切除术 腹腔镜 开腹手术 Buerger's病 

分 类 号：R651[医药卫生—外科学]