手助腹腔镜及开腹脾切除巨脾的临床疗效比较  

Comparison of hand-assisted laparoscopic splenectomy with open splenectomy for massive splenomegaly

作　　者：戴国清[1] 

机构地区：[1]同济大学附属东方医院消化外科,上海200120

出　　处：《中国普通外科杂志》2011年第12期1380-1382,共3页China Journal of General Surgery

摘　　要：目的比较手助腹腔镜(HALS)和开腹切除(OP)巨脾的临床效果。方法回顾性分析2004年—2010年行脾切除术患者的临床资料,比较其中大于20 cm脾脏行HALS和OP的临床疗效。结果大于20 cm的巨脾切除术患者41例,21例为HALS手术,20例为开腹脾切除手术。HALS组的中转开腹率4.7%。HALS和OP组的平均出血量为227 mL和887 mL(P=0.01),平均输血为0和0.6单位(P<0.05)。HALS组的住院时间比OP显著为短(4.3 d vs.8.4 d)(P=0.001)。并发症发生率两者相比无统计学差异(P>0.05)。结论 HALS是一项安全和有效的巨脾(大于20 cm)切除技术。相比开腹脾切除其住院时间更短,出血及输血更少,是一种行之有效的替代方法。Objective To compare the efficiency of hand-assisted laparoscopic splenectomy（HALS） and open splenectomy（OP） for massive splenomegaly.Methods The clinical data of patients undergoing splenectomy in our hospital between 2004 and 2010 were retrospectively analyzed to compare the clinical efficacy of HALS and OP in patients with spleen size larger than 20 cm.Results Forty-one patients with spleen size larger than 20 cm underwent splenectomy,of whom,21 cases underwent HALS and 20 cases underwent OP.The conversion rate to open surgery of the HALS group was 4.7%.The average blood loss of the HALS and OP group was 227 mL and 887 mL（P=0.01）,and blood transfusion was 0 and 0.6 units（P0.05）,respectively.The length of hospital stay of the HALS group was significantly reduced compared with that of the OP group（4.3 days vs.8.4 days）（P=0.001）,and no significant difference was noted in complications between the two groups（P0.05）.Conclusions HALS is a safe and effective splenectomy procedure for patients with spleen size larger than 20 cm,and it is a feasible alternative procedure to OP with shorter hospital stay,less blood loss and fewer blood transfusions.

关 键 词：脾切除术/方法 脾切除术 手助腹腔镜 巨脾 

分 类 号：R657.6[医药卫生—外科学]