手助腹腔镜脾切除手术治疗脾破裂安全性和可行性研究  

The safety and feasibility of hand-assisted laparoscopic technology in splenectomy with splenic rupture

作　　者：陈文辉 张龙 黄贤裕 刘嘉欣 王娟 钟鼎文[1] CHEN Wen-hui;ZHANG Long;HUANG Xian-yu;LIU Jia-xing;WANG Juan;ZHONG Ding-wen(Department of Hepatopancreatobiliary Surgery,Ganzhou People's Hospital,Ganzhou,Jiangxi 341000)

机构地区：[1]赣州市人民医院肝胆胰外科,江西赣州341000

出　　处：《赣南医科大学学报》2025年第3期237-239,254,共4页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：赣州市卫生健康委员会科研计划项目(2022-2-032);赣州市科技局科技创新人才项目(2023NS127403)。

摘　　要：目的:探讨手助腹腔镜下脾切除手术(Hand-assisted laparoscopic splenectomy,HALS)的安全性和可行性。方法:收集赣州市人民医院肝胆胰外科2021年1月至2023年12月接受HALS或传统开腹手术(Open surgery,OS)治疗脾破裂患者的临床资料及与HALS或OS相关的围手术期变量,比较2组患者的临床结局。结果:62例脾破裂患者中35例接受HALS治疗、27例接受OS治疗。HALS组术中无中转开腹手术出现。与传统OS组相比,HALS组手术时间更短(P<0.001)、术后24 h疼痛评分更低(P<0.001)、住院时间更短(P<0.001)。2组患者在术中输血、术中出血量、术后首次进食时间及手术并发症,差异无统计学意义(P>0.05)。术后90天内无死亡病例。结论:手助腹腔镜脾切除术应用于脾破裂治疗是安全、可行、有效的手术方法,值得推广。Objective:To investigate the safety and feasibility of hand-assisted laparoscopic splenectomy(HALS).Methods:We retrospectively collected patients with splenic rupture who underwent HALS or OS from January 2021 to December 2023 at the Department of Hepatopancreatobiliary Surgery,Ganzhou People's Hospital.Demographic characteristics and perioperative variables related to HALS or OS were collected,and the clinical outcomes were compared between the two groups.Results:62 patients with splenic rupture who underwent HALS(n=35)and OS(n=27)were collected in this study.There were no conversions to open surgery in the HALS group during surgery.Compared with OS,HALS showed significantly better results with shorter operative time(P<0.001),less 24 h postoperative visual analogue score(P<0.001),postoperative hospital stay(P<0.001).There was no significant difference between the two groups in terms of intraoperative transfusion,intraoperative blood loss,first food intake,overall complication(P>0.05).No ninety-day mortality occurred among the patients.Conclusion:Hand-assisted laparoscopic splenectomy is safe,feasible,and effective.It is worth promoting.

关 键 词：手助腹腔镜 脾切除术 脾破裂 

分 类 号：R657.6[医药卫生—外科学]