脾动脉加压灌注自血回输技术在腹腔镜脾切除贲门周围血管离断术中的应用  

Laparoscopic splenectomy and pericardial devascularization with artery pressure perfusion

作　　者：沈国樑[1] 洪德飞[2] 张成武[1] 张宇华[1] 王知非[1] Shen Guoliang;Hong Defei;Zhang Chengwu;Zhang Yuhua;Wang Zhifei(Department of Hepatobiliary and Pancreatic Surgery,Minimally Inasive Surgery,Zhejiang Prou incial People's Hospital,Hangzhou 310000,China;Department of General Surgery,Sir Run Run Shaw Hospital ffiliated to Medical College of Zhejiang Uniersity,Hangzhou 310000,China)

机构地区：[1]浙江省人民医院肝胆胰外科、微创外科,杭州310000 [2]浙江大学医学院附属邵逸夫医院普外科,杭州310000

出　　处：《中国医师杂志》2021年第11期1647-1650,共4页Journal of Chinese Physician

基　　金：浙江省教育厅一般科研项目(Y201534516)。

摘　　要：目的探讨经脾动脉加压灌注自血回输方法在腹腔镜脾切除贲门周围血管离断术中的临床价值。方法回顾浙江省人民医院近3年腹腔镜下脾切断流患者临床资料,对比分析30例使用脾动脉加压灌注腹腔镜脾切断流术患者(观察组)与30例常规腹腔镜脾切断流术患者(对照组)的治疗效果。结果两组患者年龄、性别、术前肝功能分级及脾脏体积差异无统计学意义(P>0.05)。所有60例患者全部完成腹腔镜下脾切断流术,无中转开腹,无死亡病例。观察组和对照组的手术前后肝功能、手术时间、术中出血量比较差异无统计学意义(P>0.05),输血情况、术后并发症情况及住院时间差异亦无统计学意义(P>0.05)。观察组术后血红蛋白水平明显高于对照组(P<0.05)。结论经脾动脉加压灌注腹腔镜下脾切断流术能安全有效地改善术后血色素水平,可以为临床节省血资源,值得临床推广应用。Objective To evaluate trans-artery pressure perfusion autologous transfusion for laparo-scopic splenectomy and pericardial devascularization(LSPD).Methods The elinical data of patients with laparoscopie splenectomy in Zhejiang Provincial People's Hospital in reent 3 years were reviewed.The therapeutic ffects of 30 ISPD cases with trans-artery pressure perfusion(observation group)and 30 radical LSPD cases(control group)were compared and analyzed.Results There was no significant difference in age,sex,preoperative liver function grade and spleen volume between the two groups(P>0.05).All 60 patients completed laparoscopic splenectomy without conversion to laparotomy or death.There was no signif-icant difference in liver function,operation time and intraoperative bleeding between the observation group and the control group(P>0.05),and there was also no significant difference in blood transfusion,postop-erative complications and hospital stay(P>0.05).The hemoglobin level in the observation group was sig-nificantly higher than that in the control group(P<0.05).Conclusions Laparoscopie splenectomy and pericardial devascularization with trans-artery pressure perfusion autologous transfusion can increase post-op-erative hemoglobin value effectively.

关 键 词：脾切除术 腹腔镜检查 输血 自体 贲门周围血管离断术 

分 类 号：R657.6[医药卫生—外科学]