手助腹腔镜脾大部切除术治疗门脉高压症的疗效评价

The clinical evaluation of hand-assisted laparoscopic splenectomy mostly for patients with portal hypertension

目的探讨使用手助腹腔镜行脾大部切除术的可行性。方法自2002年1月至2010年5月共收治38例门脉高压症患者,行传统手术脾大部切除、贲门周围血管离断、残脾原位腹膜后固定及大网膜胸骨后自然分流术20例(传统手术组);在手助腹腔镜下行脾大部切除、贲门周围血管离断、残脾原位腹膜后固定及大网膜胸骨后自然分流术18例(手助腹腔镜组)。观察并比较两组术中出血量、手术时间、术后肠蠕动恢复时间、住院费用、住院时间及术后并发症。结果手助腹腔镜组在术中出血量、术后肠蠕动恢复时间、住院时间等方面均优于传统手术组(P<0.01),而手术时间、住院费用、术后并发症差异无统计学意义(P>0.05)。结论在手助腹腔镜下行脾大部切除术是可行的。

Objective To explore the effectiveness and reliability of hand-assisted laparoscopic splenectomy （ HALS ）. Methods From January 2002 to May 2010,hand-assisted laparoscopic splenectomy mostly was performed in 18 portal hypertension patients; open surgery was performed in 20 portal hypertension patients. They were contrasted each other on objective hemorhagic volume, operating time, peristalsis recovery time, hospital charges, hospital stay, postoperative complications. Results There was remarkable significance compared with the hand-assisted laparoscopic splenectomy mostly group（ P 〈 0.01 ） on the hemorhagic volume, peristalsis recovery time, hospital stay. There was no significance compared with the control group （ P 〉 0.05 ） on the operating time, hospital charges, postoperative complications. Conclusions Hand-assisted laparoscopic splenectomy mostly is a feasible and effective measure for portal hypertension.