原位二级脾蒂离断法在脾动脉灌注联合全脾切除术治疗晚期血吸虫病脾肿大中的应用及对患者凝血功能的影响  

Application of in situ secondary splenic pedicle dissection in treatment of splenomegaly of advanced schistosomiasis with perfusion of splenic artery combined with total splenectomy

作　　者：曹晓林 CAO Xiao-lin(The Second People's Hospital of Duchang County,Duchang,Jiangxi,332600,China)

机构地区：[1]江西省都昌县第二人民医院,江西都昌332600

出　　处：《蛇志》2020年第2期179-181,共3页Journal of Snake

摘　　要：目的探讨原位二级脾蒂离断法在脾动脉灌注联合全脾切除术治疗晚期血吸虫病脾肿大中的应用及对患者凝血功能的影响。方法选取50例晚期血吸虫病脾肿大患者为研究对象,按照随机数字表法将患者分为研究组和对照组各25例。对照组采取传统全脾切除术联合脾动脉灌注治疗,研究组采取二级脾蒂离断法全脾切除术联合脾动脉灌注治疗。比较两组患者手术相关指标(手术时间、术中出血量、术后24 h引流量、拔管时间)、术前及术后24 h凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血小板(PLT)、纤维蛋白原(FIB)],并分析比较术后6个月内两组患者并发症发生情况。结果研究组手术时间、术中出血量、术后24 h引流量、拔管时间等各项指标明显优于对照组,差异有统计学意义(P<0.05)。术后24 h,两组患者的PLT、FIB水平均明显高于术前(均P<0.05),而研究组各指标水平明显低于对照组(P<0.05);两组患者PT、APTT水平均明显低于术前(均P<0.05),且研究组明显高于对照组(均P<0.05)。术后6个月内,研究组的并发症发生率略低于对照组,但差异无明显统计学意义(P>0.05)。结论原位二级脾蒂离断法全脾切除术联合脾动脉灌注治疗晚期血吸虫病脾肿大对患者造成的创伤小、术后恢复快,可抑制患者术后高凝状态,且安全性良好。Objective To investigate the application of in-situ secondary splenic pedicle dissection in the treatment of splenomegaly of advanced schistosomiasis with splenic artery perfusion combined with total splenectomy and its effect on the coagulation function of patients.Methods Fifty patients with advanced schistosomiasis and splenomegaly were selected as the study control,and the patients were divided into a study group and a control group of 25 patients according to the random number table method.The control group was treated with traditional total splenectomy combined with splenic artery perfusion,and the research group was treated with two-stage splenic pedicle dissection and total splenectomy combined with splenic artery perfusion.Comparison of surgery-related indicators(operation time,intraoperative blood loss,24 h postoperative drainage,extubation time),coagulation function indexes before and after surgery[prothrombin time(PT),activated partial thromboplastin Time(APTT),platelet(PLT),fibrinogen(FIB)],and analyze and compare the differences in complications between the two groups within 6 months after surgery.Results The operation time,intraoperative blood loss,24 h postoperative drainage,and extubation time of the study group were significantly better than the control group(P<0.05);the PLT and FIB levels of the two groups were significantly higher than those of the two groups at 24 h after operation.Before surgery,and the study group was significantly lower than the control group,the PT pole APTT level of the two groups of patients was significantly lower than before surgery,and the study group was significantly higher than the control group(P<0.05);within 6 months after surgery,the study group patients the incidence of complications was slightly lower than that of the control group,but there was no significant difference(P>0.05).Conclusion Total splenectomy with in-situ secondary splenic pedicle dissection combined with splenic arterial infusion for the treatment of advanced schistosomiasis splenomegaly will

关 键 词：原位二级脾蒂离断法 脾动脉灌注 全脾切除术 晚期血吸虫病脾肿大 

分 类 号：R657.6[医药卫生—外科学] R532.21[医药卫生—临床医学]