腹腔镜辅助小切口与传统开腹门静脉高压症手术的比较

Comparision of laparoscopy-assisted mini-incision and traditional open operation for portal hypertension

目的 探讨腹腔镜辅助门静脉高压症分流断流联合手术的临床效果。方法 比较2011年6月至2012年6月开展的38例腹腔镜辅助小切口门静脉高压症手术与30例常规传统手术的手术情况。结果 腹腔镜辅助组成功完成36例,手术时间(215.83±16.88)min,较传统手术组(174.16±12.39)min时间长,但差异无统计学意义(P=0.108);腹腔镜辅助组手术切口平均长度(8.00±1.18)cm,明显较传统手术小(P=0.020);术中出血量(340.56±56.67)ml、术后24h引流量(88.47±20.10)ml,均少于传统开腹组(P=0.000,0.044);腹腔镜辅助组术后腹腔引流管拔出时间(4.28±0.70)d及术后住院天数(6.58±0.55)d,均短于传统开腹组(P=0.007,0.005);腹腔镜辅助组术后患者发热时间(4.53±2.44)d,与传统手术组比较差异无统计学意义(P=0.057)。结论 腹腔镜辅助小切口门静脉高压症联合手术是一种安全的手术方式,与传统手术比较,具有创伤小、出血少、术后恢复快等优点。

Objective To investigate the clinical efficacy of laparoscopy-assisted mini-incisionshunt and devascularization combined operation for portal hypertension.Methods Between June.2011 andJune.2012,38 patients of portal hypertension underwent laparoscopy-assisted mini-incision operation and30 patients underwent traditional open operation.We compare the clinical results of the two procedures.Results 36 patients underwent successfully laparoscopy-assisted mini-incision operation.The surgery timeof laparoscopy group,(215.83±16.88) min,was longer than that of the traditional open operation group,(174.16±12.39)min. But there was no significant difference between the two groups (P=0.108).The meanlength of incision,(8.00±1.18)cm,was shorter than that of the traditional group (P=0.020). The meanbleeding loss, drainage of 24 hour after operation were (340.56 ±56.67)ml and (88.47 ±20.10)mlrespectively, which were less than that of the traditional group (P=0.000, 0.044).The mean time ofexudation and post-operation hospitalization were (4.28±0.70) days and (6.58±0.55)days respectively,which were shorter than that of the traditional group (P=0.007,0.005).The mean time of fever was (4.53±2.44)days,which was no significant difference between the two groups (=0.057).Conclusions Thelaparoscopy -assisted mini -incision combined operation for portal hypertension is a safe procedure.Comparing with the traditional operation,this procedure can reduce the operation trauma and blood loss.Post-operation recovery is more rapid.