3D腹腔镜脾切除术治疗肝硬化合并巨脾的临床疗效  

Clinical evaluation on three-dimensional laparoscopic splenectomy for massive splenomegaly secondary to liver cirrhosis

作　　者：田广金 何雨婷 余海波 董亚东 郝晓沛 代坤甫 李德宇 Tian Guangjin;He Yuting;Yu Haibo;Dong Yadong;Hao Xiaopei;Dai Kunfu;LI Deyu(Department of Hepatobiliary Pancreatic Surgery,Henan Provincial People′s Hospital,People′s Hospital of Zhengzhou University,People′s Hospital of Henan University,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院肝胆胰腺外科,郑州大学人民医院河南大学人民医院,郑州450003

出　　处：《中华普通外科杂志》2020年第2期135-137,共3页Chinese Journal of General Surgery

基　　金：河南省科技厅科技攻关项目(162102310021);河南省科技厅省部共建项目(201701021)。

摘　　要：目的探讨3D腹腔镜在肝硬化巨脾切除术中的临床应用。方法收集2013年1月至2018年12月河南省人民医院67例腹腔镜巨脾切除术患者的临床资料。结果2D组患者手术时间、术中出血量、输血量、输血和开腹例数多于3D组,差异有统计学意义(t=12.90,18.255,19.711,χ2=10.747,0.685,均P<0.05)。2D组患者腹腔出血、胰瘘例数、住院时间多于3D组,差异有统计学意义(χ2=3.511,4.527,t=12.969,均P<0.05)。患者均获随访,随访5~60个月(中位时间30个月)。分别有6例、5例患者出现门静脉血栓,差异无统计学意义(χ2=0.028,P>0.05),经口服华法林治愈。结论3D腹腔镜能提供更真实的视觉效果,在肝硬化巨脾切除术中优势明显。Objective To investigate the clinical effect of three-dimensional laparoscopic splenectomy for massive splenomegaly secondary to liver cirrhosis.Methods The clinical data of 67 patients who underwent laparoscopic splenectomy for massive splenomegaly at Henan Province People′s Hospital from Jan 2013 to Dec 2018 were collected.Results Operation time,volume of intraoperative blood loss and blood transfusion,number of patients with intraoperative blood transfusion,and conversion to laparotomy in 2D group were in favor of 3D group,with statistically differences(t=12.90,18.255,19.711,χ2=10.747,0.685,P<0.05).Postoperative intra abdominal bleeding,pancreatic fistula,and postoperative hospital stay were more than those in 3D group,with statistically differences(χ2=3.511,4.527,t=12.969,P<0.05).All patients were followed up for 5 to 60 months.Portal thrombosis occurred in 6 patients vs 5 patients,respectively(χ2=0.028,P>0.05)and resolved with oral coumarin.Conclusions Three-dimensional laparoscopic splenectomy can provide more realistic visual effects of surgical procedures and has an obvious advantage in laparoscopic splenectomy for massive splenomegaly secondary to liver cirrhosis.

关 键 词：腹腔镜 成像 三维 脾脏切除术 

分 类 号：R657[医药卫生—外科学]