手助腹腔镜与开腹脾切除贲门周围血管离断术治疗肝硬化门脉高压症的疗效比较  

Comparisons of clinical effect of hand-assisted laparoscopic and open splenectomy combined with pericardial devascularization for the treatment of portal hypertension in liver cirrhosis

作　　者：包汉康 韦秀丽 

机构地区：[1]惠东县第二人民医院普外科,广东惠东516351

出　　处：《临床军医杂志》2016年第1期92-94,97,共4页Clinical Journal of Medical Officers

摘　　要：目的比较手助腹腔镜和开腹脾切除贲门周围血管离断术治疗肝硬化门脉高压症的临床效果及安全性。方法回顾性分析2011年9月至2014年3月惠东县第二人民医院收治的肝硬化门脉高压症患者的临床资料,按照手术方式将其分为手助腹腔镜贲门周围血管离断术治疗组(观察组)和开腹脾切除贲门周围血管离断术治疗组(对照组)。比较两组患者的治疗效果及术后并发症。结果两组患者手术时间、术中出血量、术后引流量以及术后住院时间比较,差异均有统计学意义(P<0.05)。观察组患者的手术时间多于对照组,术中出血量、术后引流量以及术后住院时间均少于对照组(P<0.05)。两组患者的并发症主要有术后出血、切口感染、腹腔积液、肺部感染、胃瘫以及胃漏等,其中观察组患者的切口感染、腹腔积液、肺部感染的发生率低于对照组,差异有统计学意义(P<0.05);两组患者术后出血、胃瘫以及胃漏的发生率差异无统计学意义(P>0.05)。结论手助腹腔镜脾切除联合贲门周围血管离断术治疗肝硬化门脉高压症具有临床效果好、术后并发症少等特点,有积极的临床意义。Objective To compare the clinical effect and safety of hand-assisted laparoscopic and open splenectomy combined with pericardial devascularization for the treatment of portal hypertension in liver cirrhosis. Methods The clinical date of cirrhosis patients with portal hypertension in our hospital from September 2011 to March 2014 were retrospectively analyzed,which were divided into hand-assisted laparoscopic splenectomy combined with pericardial devascularization（ observation group） and open splenectomy combined with pericardial devascularization（ control group）. Comparisons of clinical effect and complications after operation were launched. Results The operative time,bleeding volume,postoperative drainage volume and postoperative hospitalization time of two groups were conducted,the difference was statistically significant（ P〈0. 05）,in which operative time of observation group was more than that of control group,and postoperative drainage volume and postoperative hospitalization time in observation group were less than these in control group. The complications of two groups after operation mainly included postoperative bleeding,incision infection,peritoneal effusion,pulmonary infection,gastroparesis and gastric leak,in which the incidence of incision infection,peritoneal effusion and pulmonary infection on observation group were lower than these in control group,the difference was statistically significant（ P〈0. 05）.There was no statistically significant difference of incidence of postoperative bleeding,gastroparesis and gastric leak in two groups（ P〈0. 05）. Conclusion Hand-assisted laparoscopic combined pericardial devascularization for the treatment of cirrhosis patients with portal hypertension has characteristic of good clinical effect,less complications,and it has an important reference value in clinical.

关 键 词：手助腹腔镜脾切除 开腹腹腔镜脾切除 贲门周围血管离断术 肝硬化 门脉高压症 

分 类 号：R657[医药卫生—外科学]