腹腔镜辅助小切口行脾切除术治疗血液系统疾病  

Laparoscopy plus small incision splenectomy in the treatment of haematologic diseases

作　　者：亓玉忠[1] 胡三元[1] 于文滨[1] 李波[1] 禹化龙[1] 

机构地区：[1]山东大学第二医院普外科,山东济南250033

出　　处：《中国普通外科杂志》2003年第12期892-893,共2页China Journal of General Surgery

摘　　要：目的　探讨腹腔镜辅助小切口脾切除治疗血液系统疾病的可行性及效果。方法　应用腹腔镜游离脾周围韧带 ,辅加小切口处理脾蒂行脾切除 ,治疗经内科治疗无效的原发性血小板减少性紫癜 (ITP )患者 16例 ,遗传性球形红细胞增多症患者 (HS) 4例。结果　本组 2 0例均顺利完成手术 ,手术时间 1.5～ 2 .5h ,平均 2 .2h。术中出血 3 0～ 85ml ,平均 65ml。无脾窝积液或术中大出血 ,无切口感染、无手术死亡。住院天数 4～ 7d ,平均 6d。术后随访 0 .5～ 2 .5年 ,平均 1.5年 ,无复发病例。结论　经腹腔镜辅助小切口脾切除对部分血液系统疾病的治疗具有微创、安全、有效、恢复快等优点 ,值得推广应用。Objective To evaluate the feasibility and effect of the treatment of hematopathy by laparoscopy plus small incision splenectomy. Methods Dissection and separation of the ligaments of the spleen with laparoscopy first. And then made a small abdominal incision to ligate and divid the pedicle of spleen to finish splenectomy. Sixteen cases of idiopathic thrombocytopenic purpura(ITP) and 4 cases of heriditary spherocytosis(HS), who were treated by medication but no effect or recurrence, were treated by this procedure. Results All the patients recovered smoothly without infection of the wound ,without fluid collection in the spleen fossa,and without great intraoperative blood loss.The operating time was 1.5～2.5h(average 2.2h), intraoperative blood loss was 30～85ml(average 65ml).Hospital stay was 4～7d( average 6d). No recurrence was found during the follow-up for 0.5 to 2.5 years in this series. Conclusions Laparoscopy plus small incision splenectomy in the treatment of some hematopathy has many advantages,such as less trauma, safety, effective and quick recovery.

关 键 词：脾切除术 腹腔镜术 血小板减少性紫癜 外科治疗 微创手术 

分 类 号：R657.6[医药卫生—外科学]