腹腔镜脾切除联合贲门周围血管离断术治疗门静脉高压症的临床价值评估  

Clinical value evaluation of laparoscopic splenectomy combined with pericardial devascularization in the treatment of portal hypertension

作　　者：李虎 孟令展 张晓峰 牛晓峰 庄云龙 朱震宇 LI Hu;MENG Lingzhan;ZHANG Xiaofeng(Department of the Fifth Medical Center,PLA General Hospital,Beijing 100039,China)

机构地区：[1]解放军总医院第五医学中心肝病医学部肝病外科四病区,北京100039

出　　处：《腹腔镜外科杂志》2024年第5期336-341,共6页Journal of Laparoscopic Surgery

摘　　要：目的:评估腹腔镜脾切除联合贲门周围血管离断术的优越性、安全性,以期为门静脉高压症手术治疗方案的选择提供依据。方法:回顾分析2017年3月至2021年11月收治的215例门静脉高压症患者的临床资料,其中研究组(n=68)行腹腔镜脾切除联合贲门周围血管离断术,从行开腹脾切除联合贲门周围血管离断术的患者中抽取68例作为对照组,比较两组围手术期相关指标、术后并发症等。结果:研究组手术时间长于对照组,术中出血量、术后住院时间、腹腔引流管留置时间、术后并发症均少于对照组,差异有统计学意义(P<0.05);两组术中自体血回输量差异无统计学意义(P>0.05)。结论:腹腔镜脾切除联合贲门周围血管离断术安全、效果显著,与传统开腹脾切除联合贲门周围血管离断术相比,具有创伤更小、术中容易暴露解剖间隙、康复快、住院时间短、并发症少的优点,值得推广应用。Objective:To evaluate the superiority and safety of laparoscopic splenectomy combined with pericardial devascularization,and to provide basis for selection of the surgical treatment scheme for portal hypertension.Methods:From Mar.2017 to Nov.2021,clinical data of 215 patients with portal hypertension were retrospectively analyzed.68 patients in study group underwent laparoscopic splenectomy and pericardial devascularization.68 patients were randomly selected from patients who underwent open splenectomy and pericardial devascularization as the control group.Perioperative indicators,postoperative complications and other clinical effects were compared between the two groups.Results:The average operative time of the study group was longer than that of the control group.The intraoperative blood loss,postoperative hospital stay,abdominal drainage time and postoperative complications in the study group were less than those in the control group,with statistically significant differences(P<0.05).The intraoperative autologous blood transfusion volume was not statistically significantly different between the two groups.Conclusions:Compared with traditional open surgery,laparoscopic splenectomy combined with pericardial devascularization is a safe and effective surgical method with little surgical trauma,easy exposure of anatomic space,quick recovery,short hospital stay and few complications,which can be widely applied.

关 键 词：高血压 门静脉 贲门周围血管离断术 脾切除术 腹腔镜检查 

分 类 号：R657.63[医药卫生—外科学]