改良原位巨脾切除对脾体积和手术安全的影响  

Effect of modified orthotopic megasplenectomy on the spleen volume and operation safety

作　　者：汪圣毅[1] 郭爱军[1] 韩涵[1] 王宁[1] 郑立平[1] 宋景戈[1] 刘弋[1] 

机构地区：[1]安徽医科大学第一附属医院普通外科,合肥230022

出　　处：《安徽医科大学学报》2014年第2期271-273,共3页Acta Universitatis Medicinalis Anhui

基　　金：安徽高校省级自然科学研究项目(编号:KJ2012Z180);安徽省博士后研究人员科研经费资助项目(2011年)

摘　　要：采用1∶4配对的病例对照方法,选择行巨脾切除的患者60例,脾静脉最后分级离断原位巨脾切除术12例为改良组,常规原位巨脾切除术48例为对照组。改良组手术前后脾脏的长径(cm)分别为19.28±3.90、18.29±2.96,脾脏厚度(cm)分别为7.21±2.54、6.41±1.11,差异无统计学意义;输血量与出血量呈正相关(r=0.717,P<0.01)。与对照组比较,改良组出血量、输血量少,不良事件发生率低,差异有统计学意义(P<0.05),改良方法安全有效。With a 1 ： 4 matched case-control study design, 60 cases underwent orthotopic megasplenectomy were selected,among them,12 cases with splenic vein＆#39;s secondary branch cutting in the last step were grouped to modi-fied group, and the other 48 cases underwent routine orthotopic megasplenectomy were grouped to control group. In modified group, before and after operation, there were no significant differences in the spleen length（ cm） （19.28＆#177;3.90 vs 18.29＆#177;2.96, P＆gt;0.05） and thickness（cm）（7.21＆#177;2.54 vs 6.41＆#177;1.11,P＆gt;0.05）,blood transfu-sion was positively correlated with bleeding（r=0.717, P＆lt;0.01）. Compared with control group,the bleeding and transfusion volume and adverse event rate were significantly reduced in the modified group, suggesting that modified orthotopic megasplenectomy was safe and effective.

关 键 词：巨脾切除 原位脾切除 门静脉高压 自身配对 匹配 

分 类 号：R657.34[医药卫生—外科学] R619.1[医药卫生—临床医学]