腹腔镜下脾动脉瘤近远端隔绝术的临床应用(附七例报告)  

Clinical application of laparoscopic proximal and distal exclusion of splenic aneurysm:a report of 7 cases

作　　者：曾志武 邓次妮 刘莉 夏辉[4] 杨光耀[4] 陈冬 周程[4] 龚昭[4] Zeng Zhiwu;Deng Cini;Liu Li;Xia Hui;Yang Guangyao;Chen Dong;Zhou Cheng;Gong Zhao(Department of General Surgery,General Hospital,Shenzhen University,Guangdong Shenzhen 518000,China;The First Affiliated Hospital of Southern University of Science and Technology,The Second Clinical Medical College,Jinan University,Shenzhen Cardiovascular Minimally Invasive Medical Engineering Technology Research and Development Center,Department of Cardiology,Shenzhen People′s Hospital,Guangdong Shenzhen 518001,China;Department of Clinical Laboratory,General Hospital of Central Theater Command,Hubei Wuhan 430010,China;Department of Hepatobiliary Surgery,Wuhan NO.1 Hospital,Hubei Wuhan 430022,China)

机构地区：[1]深圳大学总医院普外科,广东深圳518000 [2]南方科技大学第一附属医院暨南大学第二临床医学院深圳市心血管微创医学工程技术研究开发中心深圳市人民医院心脏血管疾病诊疗中心,广东深圳518001 [3]中部战区总医院检验中心,湖北武汉430010 [4]武汉市第一医院肝胆外科,湖北武汉430022

出　　处：《腹部外科》2021年第6期463-466,共4页Journal of Abdominal Surgery

基　　金：深圳市医学重点学科建设经费资助(SZXK003)。

摘　　要：目的探讨腹腔镜下脾动脉瘤近心端及远心端隔绝术在脾动脉瘤治疗中的应用。方法回顾性分析武汉市第一医院2015年1月至2019年12月期间应用腹腔镜下脾动脉瘤近远端隔绝术治疗的7例脾动脉瘤病人的临床资料。所有病人术前均行彩超、增强CT及腹部CT血管造影(CTA)检查明确诊断,术前影像学充分评估脾动脉瘤的大小、形状、位置及载瘤动脉的情况。术后常规复查血常规、C反应蛋白。1个月后复查腹部增强CT及CTA。术后所有病人均随访,时间为4~54个月。结果7例病人术后均恢复满意,无出血、胰瘘、感染、脾脏坏死、腹腔脓肿、动脉瘤复发等并发症。随访期间无死亡病例,手术应激期过后复查血常规维持在正常水平,无白细胞、血小板升高等脾功能缺失的表现。结论腹腔镜下脾动脉瘤隔断术安全可行、可操作性强、治疗效果好,值得临床推广应用。Objective To explore the application of laparoscopic proximal and distal exclusion of splenic aneurysms.Methods Clinical data were retrospectively reviewed for 7 patients of splenic aneurysms undergoing laparoscopic proximal distal exclusion from January 2015 to December 2019.All cases were preoperatively diagnosed by color Doppler ultrasound,enhanced computed tomography(CT)and abdominal computed tomography angiography(CTA).Size,shape,location and parent artery of splenic aneurysm were fully evaluated by preoperative imaging.Routine blood and C-reactive protein were examined pre-operation.One month later,abdominal enhanced CT and vascular CTA were reexamined.The follow-up period was(4-54)months.Results All patients recovered satisfactorily without such complications as bleeding,pancreatic fistula,infection,splenic necrosis,abdominal abscess or recurrence.During follow-ups,there was no mortality.After operative stress period,blood routine normalized.There was no splenic insufficiency such as leukocyte or platelet elevation.Conclusion Laparoscopic splenic aneurysm exclusion is both safe and feasible.It offers the advantages of excellent efficacy and convenient handling.A wider popularization is worthwhile.

关 键 词：腹腔镜 脾动脉瘤 脾动脉瘤隔绝术 

分 类 号：R735[医药卫生—肿瘤]