原位脾切除在肝硬化门脉高压患者术中的应用  

Study on Application of Splenenctomy in the Treatment of Cirrhotic Portal Hypertension

作　　者：沙广春[1] 王荣迅[1] 

机构地区：[1]江苏省邳州市中医院,江苏邳州221300

出　　处：《中国现代医生》2011年第12期147-148,共2页China Modern Doctor

摘　　要：目的探讨原位脾切除在肝硬化门脉高压患者术中的应用。方法 回顾性分析我院2008年6月～2010年6月73例肝炎后肝硬化患者的临床资料,其中行原位脾切除35例,行托出方法脾切除38例,比较两组脾切除时间、出血量、脾窝引流量等。结果原位切除组和托出切除组手术时间分别为(44.0±12.4)min和(39.0±16.7)min(t=1.847,P>0.05);术中平均出血量分别为(140.0±45.2)mL和(320.0±67.1)mL(t=37.284,P<0.05);术后24h平均脾窝引流量分别为(300.0±30.8)mL和(410.0±70.4)mL(t=21.692,P<0.05)。结论原位脾切除具有出血量少、脾窝引流量少、脾包膜和胃胰尾损伤小等优点,对肝硬化门脉高压患者治疗具有重要意义。Objective To study application of splenenctomy in the treatment of cirrhotic portal hypertension. Methods The clinical records of 73 patients of cirrhotic portal hypertension treated with splenenetomy from June 2008 to June 2010 were retrospectively analysed. They were divided into two groups,35 caes were treated with splenenctomy and 38 cases were treated with traditional splenenctomy. Bleeding time,blood loss and postoperative drainage volume were compared between these two groups. Results The mean bleeding time was（44.0 ± 12.4）minutes in splenenetomy group and（39.0± 16.7）minutes in traditional splenenctomy group（t=1.847,P〉 0.05）. The mean blood loss was（ 140.0 ± 45.2）mL in splenenetomy group and（320.0 ± 67.1 ）mL in traditional splenenctomy group（t=-37.284,P〈 0.05）. The postoperative drainage volume was（300.0± 30.8）mL in splenenetomy group and （410.0±70.4）mL in traditional splenenctomy （t=21.692,P〈0.05）. Conclusion Splenectomy seems to be more suitable for patients with cirrhosis portal hypertension. Comparing with conventional procedures of spleneetomy,this procedure is safer and less traumatic.

关 键 词：肝硬化 门脉高压 原位脾切除 托出法切除 

分 类 号：R657.31[医药卫生—外科学]