腹腔镜脾部分切除术和全脾切除术在脾良性占位性病变中的应用效果  

Application effects of laparoscopic partial splenectomy and laparoscopic total splenectomy in the treatment of benign splenic space-occupying lesions

作　　者：邬迪 张悦[1] 安勇[1] 陈学敏[1] 陈卫波 WU Di;ZHANG Yue;AN Yong;CHEN Xue-min;CHEN Wei-bo(Department of Hepatopancreatobiliary Surgery,the Third Affiliated Hospital of Soochow University,Changzhou First People's Hospital,Changzhou 213000,China)

机构地区：[1]苏州大学附属第三医院,常州市第一人民医院肝胆胰外科,213000

出　　处：《天津医药》2021年第10期1077-1080,共4页Tianjin Medical Journal

基　　金：国家自然科学基金资助项目(81602054);常州市科技局第九批科技计划项目(CJ20190093);常州市卫生健康委重大科技项目(ZD201906)。

摘　　要：目的比较腹腔镜脾部分切除术(LPS)与腹腔镜全脾切除术(LTS)在脾良性占位性病变中围手术期临床指标差异。方法52例患者根据病灶部位分别行LPS(脾占位位于脾的两极,22例)和LTS(病灶位于脾的中间或靠近脾门,30例)。比较2组患者的术中情况、术后恢复情况及血小板增多症的发生率。结果与LPS组相比,LTS组手术时间缩短,术中出血量和术中输血量减少(P<0.01)。2组术后排气、排便时间和下地活动时间比较差异无统计学意义(P>0.05)。LPS组拔管时间和术后住院时间均较LTS组延长(P<0.05),但总住院费用差异无统计学意义(P>0.05)。2组均无术后输血病例。LPS组住院期间和出院后随访期间血小板增多症发生率均较LTS组下降(P<0.05)。结论对于病灶位于脾边缘的患者,腹腔镜脾部分切除术是一种安全、成熟的治疗方法,能够降低术后血小板增多症的发生率。Objective To compare the difference of perioperative clinical indicators between laparoscopic partial splenectomy(LPS)and laparoscopic total splenectomy(LTS)in benign splenic space-occupying lesions.Methods Fiftytwo patients were divided into the LPS group(the lesion was located at the poles of spleen,n=22)and the LTS group(the lesion was located in the middle of spleen or close to spleen,n=30)according to the location of the lesion.The intraoperative condition,postoperative recovery and the incidence of thrombocytosis were compared between the two groups.Results Compared with the LPS group,the operation time was shortened in the LTS group,and the amount of intraoperative blood loss and blood transfusion were reduced(P<0.01).There were no significant differences in the time of exhaust,defecation and ground activity after operation between the two groups(P>0.05).The extubation time and postoperative hospital stay were longer in the LPS group than those in the LTS group(P<0.05),but there was no significant difference in total hospitalization expenses between the two groups(P>0.05).There was no postoperative blood transfusion in the two groups.The incidence of thrombocytosis during hospitalization and after discharge was lower in the LPS group than that in the LTS group(P<0.05).Conclusion For patients whose lesions are located at the edge of spleen,laparoscopic partial splenectomy is a safe and mature treatment method,which can reduce the incidence of postoperative thrombocytosis.

关 键 词：脾切除术 腹腔镜 血小板增多 脾部分切除术 全脾切除术 脾良性占位 

分 类 号：R657.6[医药卫生—外科学]