手助腹腔镜与开腹脾切断流术的对比研究  

Comparative study of hand-assisted laparoscopic and open splenectomy for portal hypertension in liver cirrhosis

作　　者：张晶[1] 薛焕洲[1] 姜青峰[1] 李珂[1] 田玉伟[1] 王要轩 

机构地区：[1]郑州大学人民医院肝胆外科,郑州450003

出　　处：《医药论坛杂志》2016年第12期18-20,共3页Journal of Medical Forum

摘　　要：目的探讨手助腹腔镜(HALS)与开腹脾切断流术在肝硬化门静脉高压症治疗中的临床应用价值。方法对比2014年10月—2015年10月行脾切除断流术的53例肝硬化门静脉高压症患者资料,其中手助腹腔镜组23例、开腹组30例。比较两组患者术前、术中及术后临床指标情况。结果两组在术前临床指标、手术时间、术后血栓形成情况方面比较,差异无统计学意义(P>0.05)。HALS组在切口长度、肠道功能恢复方面、术中出血量、腹腔引流时间、引流液量、术后住院天数、术后并发症上明显少于开腹组(P<0.05)。而HALS组在住院总费用多于开腹组(P<0.05)。结论手助腹腔镜脾切断流术保留了微创的同时,又降低了手术难度,具有一定的临床应用价值。Objective To compare prospectively the effects of hand-assisted laparoscopy（ HALS） and open splenectomy on the clinical application value in patients with portal hypertension in liver cirrhosis. Methods From October 2014 to October 2015,retrospective analysis 53 patients with portal hypertension in liver cirrhosis needs to do splenectomy plus portal-azygous disconnection procedure. There were 23 patients was treated with HALS,and 30 patients was treated with open procedure. Results In the aspects of preoperative clinical indicators,operative time and the postoperative thrombosis between the two groups makes no difference（ P＜0. 05）. But Incision length,the intestinal function recovery,intraoperative bleeding,postoperative abdominal drainage time,postoperative drainage fluid volume,the postoperative hospitalization days were significantly shorter in HALS as compared with open Sugiura procedure（ P＜0. 05）. The in-patients costs were significantly higher in HALS as compared with open Sugiura procedure（ P＜0. 05）. Conclusion Hand-assisted laparoscopic splenectomy retains the minimally invasive,and reduces the operation difficulty. It is a rational and practical procedure for clinical application.

关 键 词：手助腹腔镜 脾切断流术 门静脉高压症 

分 类 号：R657.6[医药卫生—外科学]