全腹腔镜与开腹手术治疗门静脉高压症的临床对比研究  

Clinical comparative study of laparoscopy versus open surgery in the treatment of portal hypertension

作　　者：姚英民[1] 郑鑫[1] 吴振华[1] 李常恩[1] 刘青光[1] 

机构地区：[1]西安交通大学医学院第一附属医院肝胆外科,西安710061

出　　处：《中国实用外科杂志》2010年第5期378-380,共3页Chinese Journal of Practical Surgery

基　　金：陕西省科技攻关项目基金(2007K09-05)

摘　　要：目的研究全腹腔镜下脾切除联合贲门周围血管离断术较传统手术的优缺点,并进一步探讨其临床应用的可行性、优越性以及手术技巧。方法统计分析西安交通大学医学院第一附属医院肝胆外科于2007年2月至2008年7月实施的7例全腹腔镜下脾切除联合贲门周围血管离断术病例的术前一般情况,并依此选定开腹手术对照组病例。模拟随机对照研究方法,回顾性分析两组围手期重要指标。结果腹腔镜组出血量以及术后住院时间明显少于开腹手术对照组,而两组术后并发症、手术时间以及住院费用差异无统计学意义。结论全腹腔镜脾切除联合贲门周围血管离断术可安全地应用于临床。较传统开腹手术,其具有损伤小、恢复快、伤口美观等优点,但应严格掌握适应证、由熟练的专业医师操作以预防术中危险发生。Objective To evaluate the advantage of total laparoscopie spleneetomy and pericardial devaseularization compared to traditional open operation and investigate its feasibility, superiority and operation skill. Methods The preoperation data of 7 patiens who had received total laparoscopic splenectomy and pericardial devascularization in the First Affiliated Hospital of Medical College of Xi＇ an Jiaotong University from February 2007 to July 2008 were retrospectively analyzed. And according to the result, open operation control group was selected. Simulating the random controlled trial （RCT）, the perioperative data between both groups were retrospectively analyzed. Results The intraoperaive blood loss and length of postoperative hospitalization were both obviously less in the laparoseope group. However, the operative time , postoperative complication and cost of hospitalization were similar in both groups. Conclusions Total laparoseopie splenectomy and perieardial devascularization can be applicated safely in the treatment of portal hypertension.Compared to the traditional open operation, there are several advantages such as minimal invasion, faster recovery, beautiful outlook and so on. But it must be cautious to control the indication and select the performers.

关 键 词：腹腔镜 脾切除术 贲门周围血管离断术 

分 类 号：R6[医药卫生—外科学]