基于海况模拟平台的脾切除术的可行性研究  

Feasibility study of splenectomy based on sea state simulation platform

作　　者：邹贵军[1] 马睿[1] 牟思龙 王明琨 袁新普 马冰[1] 张朝军 Zou Guijun;Ma Rui;Mu Silong;Wang Mingkun;Yuan Xinpu;Ma Bing;Zhang Chaojun(Department of General Surgery,The First Medical Centre,PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心普通外科医学部,北京100853

出　　处：《中华航海医学与高气压医学杂志》2024年第5期596-600,共5页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

基　　金：解放军总医院院内创新项目(CX19020)。

摘　　要：目的探索不同海况条件下实施脾切除术的可行性与安全性。方法将20只比格犬按照随机数字表法分为4组:A组(0级海况)、B组(2级海况)、C组(5级海况)、D组(8级海况),每组5只,均行脾切除术,记录手术时间、术中出血量及完成情况,观察术后C反应蛋白(CRP)水平、血红蛋白水平及2周内存活状态。结果4组实验犬手术均顺利完成,术后2周内无1只死亡,无并发症发生。4组实验犬术中出血量比较差异无统计学意义(P>0.05);脾切除时间比较差异有统计学意义(P<0.001),其中:D组[(39.80±1.39)min]较A、B、C组手术时间长(均P<0.05),C组[(33.20±1.86)min]较A、B组手术时间长(均P<0.05),A组[(24.40±2.50)min]、B组[(26.00±1.30)min]手术时间比较差异无统计学意义(均P<0.05)。4组实验犬术前及术后第1、3、7天血红蛋白水平比较差异均无统计学意义(均P>0.05);4组实验犬术后第1天、第3天CRP水平均明显高于术前,术后第7天CRP水平较术后第1天、第3天下降,但仍高于术前,差异均有统计学意义(均P<0.05)。结论8级及以下等级海况下,在船舶上实施脾切除术是安全、可行的。Objective To investigate the feasibility and safety of splenectomy under different sea conditions.Methods A total of 20 beagle dogs were divided into four groups by the random number table method:Group A(Grade 0 sea condition),Group B(Grade 2 sea condition),Group C(Grade 5 sea condition),and Group D(Grade 8 sea condition),with five dogs in each group,and splenectomy was performed for all of them.The operation time,intraoperative blood loss,and operation completion status were recorded,and the level of CPR and hemoglobin after operation and the survival rate within two weeks after surgery were observed.Results All the operations in the four groups were successfully completed,and no animal died two weeks after surgery,and no complications occurred.There was no statisctically significant difference in intraoperative blood loss among the four groups(P>0.05).The difference of splenectomy duration was statistically significant(P<0.001):the operation time of Group D[(39.80±1.39)min]was longer than that of Group A,B,and C(P<0.05).Compared with Group A and B,the operation time of Group C was longer[(33.20±1.86)min](P<0.05).There was no statistically significant difference in operation time between Group A[(24.40±2.50)min]and Group B[(26.00±1.30)min](P>0.05).There was no statistically significant difference in hemoglobin level between the four groups before surgery and at the 1st,3rd,and 7th day after surgery(P>0.05).The levels of CRP in all experimental dogs on the 1st and 3rd day after surgery were significantly higher than that before operation with statistically significant differences(P<0.05);the CRP level on the 7th day after surgery was lower than those on the 1st and 3rd day after surgery,but it was still higher than that before surgery;all differences were statistically significant(P<0.05).Conclusion It is safe and feasible to perform splenectomy in sea conditions below Grade 8.

关 键 词：海上救援 海况 脾切除术 模拟实验 

分 类 号：R657.6[医药卫生—外科学]