门脉高压症原位脾切除术与传统脾切除术并发症比较分析  

Comparision and Analysis of Complications of Orthotopic Splenectomy and Traditional Splenectomy in Portal Hypertension

作　　者：宿宝栋[1] 郭连明 丁维宝[1] 杜福田[1] 

机构地区：[1]潍坊市人民医院肝胆外科,山东潍坊261041

出　　处：《潍坊医学院学报》2015年第5期385-387,共3页Acta Academiae Medicinae Weifang

摘　　要：目的 通过回顾性研究,比较分析原位脾切除术与传统脾切除术在治疗肝硬化门脉高压症中的出血量等并发症情况,提供一定临床指导意义. 方法 回顾潍坊市人民医院肝胆外科2003~2013年因肝硬化门脉高压症行单纯脾切除病例,共98例,按照手术方式分为原位脾切除组46例,传统脾切除组52例,统计手术中出血、输血等并发症情况,进行统计学分析比较. 结果原位脾切除组及传统脾切除组出血量分别为（281.63±109.30）ml,（422.45±153.00）ml,P〈0.05;原位脾切除组0例发生胰瘘,传统脾切除组5例（9.61%）发生胰瘘,P〈0.05;原位脾切除组中11例（31.42%）输血,传统脾切除中27例（51.92%）输血,P〈0. 05. 结论 较传统脾切除术,原位脾切除术可减少手术中的出血量及手术输血,且术后胰瘘等并发症的发生率明显低于传统脾切除术. 对于肝硬化门脉高压症患者,原位脾切除术较传统脾切除术更具优势.Objective To compare and analyse hemorrhage and complications of orthotopic splenectomy and traditional splenec-tomy by retrospective study .Methods Collected and looked up the illness records of hepatobiliary surgery of Weifang people ＆#39;s hospital from 2003 to 2013 which was diagnosed Hepatic Cirrhosis （ HC） and Portal Hypertension （ PH） and picking the records merely had splenectomy . The total records were 98 cases and were divided into two groups ,according to different surgery methods .The orthotopic splenectomy group had 46 records,and the traditional splenectomy group had 52 records.Obtained the clinical data and did statistical analysis .Results The blood loss of the orthotopic splenectomy group and the traditional splenectomy group were （281.63±109.30）ml and （422.45±153.00）ml （P〈0.05）.The orthotopic splenectomy group had no pancreatic fistula and the traditional splenectomy group had 5（9.61%）,P〈0.05.The orthotopic splenectomy group had 11（31.42%） need transfusion and the traditional splenectomy group had 27（51.92%）,P〈0.05.Con-clusions Compared with traditional splenectomy ,orthotopic splenectomy can reduce the blood loss and transfusion in the operation and re-duce the incidence of pancreatic fistula .Orthotopic splenectomy is superior to traditional splenectomy in merely splenectomy patients of HC and PH.

关 键 词：脾切除术 肝硬化 门脉高压症 巨脾 

分 类 号：R657.6[医药卫生—外科学]