巨脾切除126例的治疗经验  

Treatment experience of megalosplenia resection:a report of 126 cases

作　　者：黄明魁 乔海泉[1] 

机构地区：[1]哈尔滨医科大学第一临床医学院普外科,哈尔滨150001

出　　处：《腹部外科》2016年第2期112-115,共4页Journal of Abdominal Surgery

基　　金：卫生部行业科研专项"门静脉高压症治疗方法的合理选择和推广应用(201002015)"

摘　　要：目的总结巨脾切除126例的治疗经验。方法对1997年10月至2015年10月间由同一医疗组收治的126例巨脾切除病例进行回顾性分析。结果本组126例病人,其中125例痊愈出院,27例术后出现并发症,其中腹腔出血4例;肺部并发症12例,其中肺部感染7例,左侧胸腔积液、肺不张5例;门静脉血栓6例;大量腹水4例;切口呲开1例;26例经再次手术或保守治疗后痊愈,1例腹腔出血因合并DIC经治疗无效死亡。全组无胰漏、无胃底及结肠损伤。结论行巨脾切除术时,应熟悉巨脾的解剖变异与机体的代偿性改变,掌握手术操作要领及技巧,通过规范化、合理化及妥善的围手术期处理,降低并发症的发生率,是确保巨脾切除安全的关键。Objective To summarize the treatment experience of megalosplenia resection of 126 cases.Methods The clinical data of 126 cases of megalosplenia admitted at our department by the same team from October 1997 to October 2015 were analyzed retrospectively.Results 125 cases were recovered and discharged,and 1 died because of postoperative intraperitoneal hemorrhage and DIC. The postoperative complications occurred in 27 cases,including 4 cases of intra-abdominal hemor-rhage,12 cases of pulmonary complications （7 cases of lung infection,5 cases of left pleural effusion with atelectasis）,6 cases of portal vein thrombosis,4 cases of mass ascites and 1 case of incision de-hiscecence.The 26 cases were cured by reoperation or conservation treatment.No pancreatic leakage, and gastric or colonic inj ury occurred.Conclusions It is essential to be familiar with the anatomic vari-ations of magalosplenia and physiological compensatory mechanism.Besides,in order to perform sple-nectomy safely,it is important to improve operation techniques as well as perioperative management to reduce the incidence rate of complications.

关 键 词：巨脾 脾切除术 门静脉高压症 

分 类 号：R657.6[医药卫生—外科学]