腹腔镜脾切除术与开腹脾切除术的疗效观察  

Clinical outcome of laparoscopic splenectomy vs open splenectomy

作　　者：毕永辉[1] 孙绍伟[1] 林鑫星 

机构地区：[1]威海市立医院肝胆外科,264200 [2]江苏大丰人民医院普外科

出　　处：《中华普通外科学文献（电子版）》2014年第5期53-55,共3页Chinese Archives of General Surgery(Electronic Edition)

摘　　要：目的比较腹腔镜脾切除术(LS)与开腹脾切除术(OS)的临床疗效。方法2011年7月至2013年7月,选择同期分别行腹腔镜脾切除术(腹腔镜组)和开腹脾切除术(开腹组)的患者,各12例。对比分析两组患者的临床资料,包括手术时间、术中出血量、禁食时间、术后切口疼痛评分、术后住院时间等。结果与开腹组相比,腹腔镜组患者的手术时间[(170±9.7)min vs(89±4.4)min,t=24.087]、术后禁食时间[(40±8.4)h vs(68±5.8)h,t=8.558]以及术后住院时间[(7.3±0.8)d vs(13.2±0.9)d,t=-15.122]更短,术中出血量更少[(94±4.7)ml vs(170±20.7)ml,t=-11.355],术后第1天切口疼痛评分[(3.1±0.8)分vs(5.5±0.5)分,t=8.813]和第3天评分[(1.2±0.4)分vs(2.7±0.5)分,t=8.115]明显优于开腹组,差异均有统计学意义(P<0.01)。结论腹腔镜脾切除术具有创伤小、术后恢复快、并发症发生率低等特点,值得临床推广应用。Objective To compare the clinical outcome of laparoscopic splenectomy versus open splenectomy. Methods Clinical parameters of twelve cases treated with laparoscopic splenectomy and another twelve with open splenectomy were enrolled from July 2011 to July 2013. The clinical parameters such as operative time, blood loss, fasting time, postoperative wound pain scores, postoperative hospital stay were analyzed statistically. Results Compared to the open surgery group, splenectomy group had shorter operation time [（170±9.7） min vs （89±4.4） min, t=24.087], postoperative fasting time[（40±8.4） h vs （68±5.8） h, t=8.558], and postoperative hospital stay[（7.3±0.8） d vs （13.2±0.9） d, t=-15.122]. VAS on postoperative day 1 and day 3 of splenectomy group were both significantly less than the other group [（3.1±0.8）vs（5.5±0.5）, t=8.813;（1.2±0.4）vs（2.7±0.5）, t=8.115] （P〈 0.01）. Conclusion Laparoscopic splenectomy is a better choice for the patients, with less trauma, less pain, and lower rate of complications.

关 键 词：脾切除 腹腔镜 预后 

分 类 号：R657.6[医药卫生—外科学]