严重粘连性巨脾外科手术临床分析  

The clinical analysis of surgical treatment of severe adhesive megalosplenia

作　　者：牛磊[1] 王春喜[1] 朱丽文[1] 

机构地区：[1]解放军总医院普外科军医进修学院,北京100853

出　　处：《中国医药导报》2012年第16期66-67,70,共3页China Medical Herald

基　　金：吴阶平医学基金(基金号:320675008180)

摘　　要：目的总结严重粘连性巨脾切除术的治疗方法。方法对1998年1月～2010年12月我院收治的59例严重粘连性巨大脾脏患者切除术,分析术前相关资料、术中病理解剖特点、特殊处理措施、术后并发症的处理以及临床疗效。结果 59例均获得临床痊愈,无围术期死亡及胃、肠道穿孔等严重损伤,其中15例术后出现肺部感染、肺不张、腹水以及脾静脉血栓性静脉炎等,发生率为25.4%。结论充分的术前评估,规范的手术操作,仔细的脾周粘连组织分离以及脾蒂的正确离断,是确保严重粘连性巨大脾脏切除的关键。Objective To smmarize the operative treatments of 59 cases with severe adhesive megalosplenia.Methods According to the 59 operated cases of severe adhesive megalosplenia cases were collected in our hospital from January 1998 to December 2010,the preoperative information,pathological features,special measures of intraoperative,the treatment of Postoperative complications and the clinical efficacy were retrospectively analyzed.Results The 59 cases were all clinically cured without any death or serious complications such as gastrointestinal perforation,etc.The 15 of 59 cases were occurred mild complication（ulmonary infection,atelectasis,ascite and splenic phlebothrombosis）,which occupied 25.4% of the 59 cases.Conclusion The careful evaluation before operation,standardized operative procedure,reasonable,effective dissection of perisplenic adhesion and the splenic peduncular cut,are the key roles to ensure the successful surgical adhesiectomy of severe megalosplenia.

关 键 词：巨大脾脏 脾切除 门静脉高压症 

分 类 号：R657.6[医药卫生—外科学]