隧道法行腹腔镜下脾切除术的临床研究  

Clinical study of laparoscopic splenectomy by tunnel method

作　　者：吴鹏 许维[1] 王壮 郑世海 宋劲松[1] Wu Peng;Xu Wei;Wang Zhuang;Zheng Shihai;Song Jinsong(Department of General Surgery,The First Peoples Hospital of Tianmen City,Tianmen Hubei Province 413700,China)

机构地区：[1]湖北省天门市第一人民医院普外科,湖北天门431700

出　　处：《中华普外科手术学杂志（电子版）》2024年第3期319-322,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的探讨隧道法行腹腔镜下脾切除术的可行性、安全性及有效性。方法回顾性分析同一术者团队在2022年1月至2022年12月期间行腹腔镜下脾切除术48例患者的临床资料,按照离断脾蒂的方式分为A组(隧道法腹腔镜下脾切除术,n=23)和B组(常规法腹腔镜下脾切除术,n=25)。采用SPSS 22.0统计学软件进行数据分析,围手术期各项指标等计量资料用(x±s)表示,组间比较采用独立样本t检验;术后并发症等计数资料组间比较采用χ^(2)检验。P<0.05为差异有统计学意义。结果A组患者均顺利完成隧道法腹腔镜下脾切除术,无中转开腹病例;B组患者23例完成常规法腹腔镜下脾切除术,2例中转开腹。手术时间、术后住院时间和术中出血量A组患者少于B组,差异均有统计学意义(P<0.05);两组术后胰瘘、静脉血栓、出血及死亡患者例数比较,差异均无统计学意义(P>0.05)。结论隧道法行腹腔镜下脾切除术是可行、安全、有效的。Objective To investigate the feasibility,safety and effectiveness of laparoscopic splenectomy by tunnel.Methods The clinical data of 48 patients who underwent laparoscopic splenectomy from January 2022 to December 2022 by the same surgical team were retrospectively analyzed and divided into group A(tunnel laparoscopic splenectomy,n=23)and group B(conventional laparoscopic splenectomy,n=25)according to the method of splenic pedicle amputation.SPSS 22.0 statistical software was used for data analysis.Measurement data such as perioperative indicators of patients were represented by(x±s).Independent sample t test was used for comparison between groups.Theχ^(2)test was used to compare the number of postoperative complications among different data groups.P<0.05 was considered statistically significant.Results All patients in group A successfully completed the tunnel laparoscopic splenectomy,and no conversion to laparotomy cases.In group B,23 patients underwent laparoscopic splenectomy and 2 patients underwent laparotomy.Operation time,postoperative hospital stay and intraoperative blood loss in group A were less than those in group B,and the differences were statistically significant(P<0.05).There was no significant difference in the number of postoperative pancreatic fistula,venous thrombosis,hemorrhage and death between the two groups(P>0.05).Conclusion Tunnel laparoscopic splenectomy is feasible,safe and effective.

关 键 词：脾切除术 腹腔镜 隧道法 手术后并发症 

分 类 号：R657.6[医药卫生—外科学]