腹腔镜脾部分切除术在外伤性脾破裂治疗中的临床效果及安全性分析  

Clinical effect and safety of laparoscopic partial splenectomy in treatment of traumatic splenic rupture

作　　者：王云 张楠 WANG Yun;ZHANG Nan(Xinan County the 2nd Peoples Hospital,Xinan,Henan 471800,China;The Ist Affiliated Hospital of Henan University TCM Universty,Zhengzhou 450000,China)

机构地区：[1]新安县第二人民医院普外科,河南新安471800 [2]河南省中医药大学第一附属医院普外科,郑州450000

出　　处：《医药论坛杂志》2023年第5期80-83,共4页Journal of Medical Forum

摘　　要：目的探讨腹腔镜脾部分切除术在治疗外伤性脾破裂中的临床疗效及安全性分析。方法将新安县第二人民医院于2014年10月—2021年10月收治的外伤性脾破裂患者共62例作为本次观察对象并采用回顾性病例对照研究,依据手术方式将患者分为腹腔镜脾部分切除术组(LPS组)32例和腹腔镜全脾切除术组(LTS组)30例。比较两组患者手术时间、术中出血量、术后引流管放置时间、术后排气时间、住院时间、术后并发症发生情况以及术后血小板计数。结果LPS组患者较LTS组相比,其手术时间、术中出血量、术后引流管放置时间及术后排气时间无显著性差异(P>0.05),而患者住院时间、术后相关并发症的发生率显著降低(P<0.05),且对术后血小板计数的影响相对较小(P<0.05),两组患者的基本资料无显著性差异(均P>0.05)。结论相较腹腔镜全脾切除术而言,使用腹腔镜脾部分切除术治疗外伤性脾破裂是安全可行的,并在减少术后住院时间、降低术后并发症以及减少术后血小板增高风险等方面具有一定的优势。Objective To investigate the clinical efficacy and safety of laparoscopic partial splenectomy in the treatment of traumatic splenic rupture.MethodsA total of 62 patients with traumatic splenic rupture admitted to our hospital from October 2014 to October 2021 were selected as the observation objects and a retrospective case-control study was conducted.According to the surgical methods,the patients were divided into laparoscopic partial splenectomy group(LPS group,32 cases)and laparoscopic total splenectomy group(LTS group,30 cases)to compare the operative time of the two groups Intraoperative blood loss,postoperative drainage tube placement,postoperative exhaust time,postoperative length of hospital stay,postoperative complications and postoperative platelet count.ResultssCompared with LTS group,LPS group had no significant diference in operative time,intraoperative blood loss,postoperative drainage tube placement time and postoperative exhaust time(P>0.05),while the length of hospital stay was significantly reduced in the incidence of postoperative complications(P<0.05),and had relatively lttle influence on postoperative platelet count(P<0.05),there was no significant difference in basic information between 2 groups(both P>0.05).Conclusion Compared with laparoscopic total splenectomy,laparoscopic partial splenectomy is safe and feasible in the treatment of traumatic splenic rupture,and has certain advantages in reducing postoperative hospital stay,reducing postoperative complications and reducing the risk of postoperative thrombocytopenia.

关 键 词：腹腔镜脾部分切除术 腹腔镜全脾切除术 外伤性脾破裂 

分 类 号：R657.6[医药卫生—外科学]