期刊文献+

腹腔镜脾切除及贲门周围血管离断术治疗门静脉高压症的疗效评价 被引量:8

Efficacy and safety of laparoscopic splenectomy plus pericardial devascularization for patients with portal hypertention
下载PDF
导出
摘要 目的比较门静脉高压症病人行腹腔镜和开腹脾切除及贲门周围血管离断术的临床效果,评估腹腔镜手术的安全性及有效性。方法回顾性分析2010年1月至2014年5月开展的腹腔镜脾切除及贲门周围血管离断术(laparoscopic splenectomy splenectomy plus pericardial devascular—ization,18)103例病人和开腹脾切除及贲门周围血管离断术(open splenectomy plus perieardial devas—cularization,0S)110例病人的临床资料。结果两组病人手术均获得成功,无围手术期死亡,术后均康复出院,术后随访半年内无明显并发症。LS组中转开腹2例(中转率为1.9%)。LS组的平均手术时间长于OS组[(334.2±41.2)rain与(241.7±49.1)min,P=0.027];而LS组与OS组比较,术中出血量[(793.3±113.2)ml与(914.5±89.1)ml,P=0.009]、术后腹腔总引流量[(834.1±95.4)ml与(1008.1±126.2)ml,P=0.016]均明显减少,术后排气时间E(42.7±9.3)h与(56.3±7.1)h,P=0.01]、术后住院时间[(7.5±0.9)d与(8.9±0.9)d,P=0.043]明显缩短,术后并发症发生率差异无统计学意义(P〉0.05)。结论门静脉高压症病人行腹腔镜脾切除及贲门周围血管离断术安全有效,比传统开腹手术具有微创的优势。 Objective To evaluate the efficacy and safety of laparoscopic splenectomy plus pericardial devascularization (LS) versus open splenectomy plus pericardial devascularization (OS) for pa- tients with liver cirrhosis and portal hypertension. Methods Retrospective analyses were performed for the clinical data of 103 cases of LS and 110 cases of OS from January 2010 to May 2014. Results The operations of two groups were successfully performed without perioperative mortality. All patient recovered. After discharge, no complications occurred during a 6-month follow-up. In group LS, 2 cases converted into laparotomy (a conversion rate of 1.9 %). The mean operative duration was longer in LS than that that in OS [(334. 2 ±41.2)vs (241.7± 49. 1)min,P = 0. 027]. In group LS, blood loss [(793. 3 ± 113. 2) vs (914. 5 ± 89. 1) ml, P = 0. 009], total abdominal drainage volume [(834. 1 ±95. 4)vs (1008. 1 + 126. 2)ml, P = 0. 016], mean time of bowel function recovery [(42. 7 ± 9. 3) vs (56. 3±7. 1) hours, P = 0. 011) and postoperative hospitalization decreased significantly than OS [(7. 5± 0. 9)vs. (8. 9 ± 0. 9)days, P = 0. 043]. No significant inter-group difference existed in liver function or'mean weight of excised spleen (P〉0. 05). The incidence of postoperative complications showed no statistical significance (P〉0. 05). Conclusions For portal hypertension, the clinical efficacies of LS are better than those of OS.
机构地区 武汉
出处 《腹部外科》 2014年第5期373-376,共4页 Journal of Abdominal Surgery
关键词 腹腔镜 脾切除术 门静脉高压症 贲门周围血管离断术 Laparoscopes Splenectomy Hypertension, portal Pericardial devascularization
  • 相关文献

参考文献2

二级参考文献16

  • 1康建省,乔占英,侯森林,吕海涛.腹腔镜脾切除术中脾蒂处理方法的探讨[J].中国内镜杂志,2004,10(7):75-76. 被引量:13
  • 2郑朝旭,吴志棉,陈国泰,谭敏,李文姬,余俊峰,赵振献,陈流华.腹腔镜脾切除术治疗难治性特发性血小板减少性紫癜[J].中国微创外科杂志,2005,5(1):52-53. 被引量:8
  • 3鲁发龙,陶凯雄,王国斌.腹腔镜脾切除联合贲门周围血管离断术的临床应用[J].中国微创外科杂志,2005,5(1):54-55. 被引量:15
  • 4黄飞,卢榜裕,蔡小勇,陆文奇,黄玉斌.腹腔镜脾切除(附20例报告)[J].中国内镜杂志,2005,11(11):1150-1152. 被引量:28
  • 5Park AE,Birgisson G,Mastrangelo MJ,et al.Laparoscopic splenecotomy:outcomes and lessons learned from over 200 cases[J].Surgery,2000,128(4):660-667.
  • 6Rege RV,Merriam LT,Joehl RJ,et al.Laparoscopic splenectomy[J].Surg Clin North Am,1996,76(3):459-468.
  • 7Hashizume M,Ohta M,Kishihara F,et al.Laparoscopic splenectomy for idiopathic purpura:comparison of laparoscopic surgery and conventional open surgery[J].Surg Laparosc Endosc,1996,6(2):129-135.
  • 8[7]王秋生,张阳德,主译.内镜腹腔镜外科学.第1版.北京:中国医药科技出版社,2001.149-150.
  • 9[1]Kucuk C,Sozuer E,Ok E,et al.Laparoscopic versus open splenectomy in the management of benign and malignant hematologic diseases:a ten-year single center experience.Laparoendosc Adv Surg A,2005,15 (2):135-139.
  • 10[3]Poulin EC,Mamazza J,Schlachta CM.Splenic artery embolization before laparoscopic splenectomy.An update.Surg Endosc,1998,12:870-875.

共引文献30

同被引文献95

引证文献8

二级引证文献38

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部