经脐单孔LS治疗门静脉高压症及脾脏病变疗效观察  

作　　者：李彦[1] 徐鹿平[1] 李晓欢[1] 梅小平[1] 邱会文 

机构地区：[1]浙江省嘉兴市第一医院肝胆外科,314000

出　　处：《浙江临床医学》2016年第11期1998-2000,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省嘉兴市科技局项目（2012AY1070-8）

摘　　要：目的：比较分析经脐单孔腹腔镜脾切除术治疗门静脉高压症及脾脏病变的临床疗效。方法收集34例经脐单孔腹腔镜脾切除术治疗门静脉高压症及脾脏病变的临床资料，其中腹腔镜脾切除术治疗门静脉高压症12例，腹腔镜脾切除术治疗脾脏病变22例，分析门静脉高压组及脾脏病变组的手术时间、术中出血量、中转开腹率、术中输血率、术后引流量、术后住院天数、术后并发症发生率等指标，进行比较分析。结果门静脉高压组手术时间明显长于脾脏病变组（P〈0.01），术中出血量多于脾脏病变组（P〈0.05），差异有统计学意义；两组在中转开腹率、术中输血率、术后引流量、术后住院天数、术后并发症发生率等指标方面差异无统计学意义（P＆gt;0.05）。结论经脐单孔腹腔镜脾切除术治疗门静脉高压症及脾脏病变均是安全可行的，但腹腔镜脾切除术治疗门静脉脉高压症手术难度较高，手术适应证、禁忌证的把控及手术技巧和经验的掌握是控制手术风险的关键。Objective To compare the clinical efficacy between laparoscopic splenectomy for portal hypertension and splenic masses. Methods 34 cases of laparoscopic splenectomy in the treatment of portal hypertension and spleen accounted for the clinical data,including 12 cases of laparoscopic splenectomy in the treatment of portal hypertension,laparoscopic splenectomy for splenic accounted for 22 cases,retrospective analysis of portal hypertension group and spleen for byte in operative time,bleeding volume,rate of conversion to laparotomy,intraoperative blood transfusion,postoperative drainage, postoperative hospital stay,postoperative complication rate and other indicators,statistical comparisons were performed. Results Portal hypertension group,the operation time was significantly longer than that of the splenic lesions（224.3±34.2min vs 157.6±44.7min,P〈0.01）,intraoperative hemorrhage volume was higher than that of the splenic lesions（P〈0.05）,the difference is statistically significant;two groups in open laparotomy rate,intraoperative blood transfusion rate,postoperative drainage,postoperative hospital stay,postoperative complication,and other indicators of differences had no statistical significance（P＆gt;0.05）. Conclusion Laparoscopic splenectomy for portal anti hypertensive spleen and splenic accounted for all is safe and feasible,but laparoscopic splenectomy for portal hypertension spleen anti operation difficulty is high and indications for surgery complications and contraindications to master control and operation skill and experience is key to control the operation risk.

关 键 词：腹腔镜脾切除术 门静脉高压症 脾脏病变 

分 类 号：R657.34[医药卫生—外科学]