手助腹腔镜脾切除术治疗巨脾的临床效果分析

Clinical effect analysis of hand-assisted laparoscopic splenectomy in the treatment of splenomegaly

目的探究对巨脾患者行手助腹腔镜脾切除术的可行性、安全性及手术技巧。方法选取我院2012年12月~2014年12月收治的72例巨脾患者,将其随机分为观察组与对照组,每组36例。观察组患者采用手助腹腔镜脾切除术进行治疗,对照组采用传统脾切除术进行治疗,治疗结束后对两组患者的治疗效果进行对比、分析。结果观察组的手术均成功,无中转开腹;与对照组相比,观察组手术时间长,术中出血量少,术后排气时间早,住院时间短,两组比较差异有统计学意义（P〈0.05）,其中对照组发生术后切口感染1例,观察组无患者发生并发症,两组并发症发生率差异无统计学意义（P〉0.05）。结论对巨脾患者行手助腹腔镜脾切除术具有术中出血量少、术后排气早的优点,能够缩短患者的住院时间,是一种安全可靠的治疗方式,值得临床推广与应用。

Objective To explore the feasibility,safety and surgical techniques of hand-assisted laparoscopic splenectomy in patients with splenomegaly. Methods 72 patients with splenomegaly admitted into our hospital from December 2012 to December 2014 were selected and evenly divided into observation group and control group in random.In the observation group,hand-assisted laparoscopic splenectomy was applied,while in the control group,traditional splenectomy was adopted.After therapy,the therapeutic effect in two groups was compared and analyzed.Results In the observation group,the surgeries were all successful,and no case was transferred to laparotomy.Compared with the control group,the operation time was shorter,intraoperative amount of bleeding was less,the postoperative exhaust time was earlier,and hospital stay was shorter in the observation group,the differences were significant between the two groups（P 0.05）.In the control group,1 case was complicated with incision infection after surgery,in the observation group,no complications occurred,there was no significant difference in the incidence of complications between the two groups（P 0.05）. Conclusion Implementation of hand-assisted laparoscopic splenectomy in patients with splenomegaly has advantages of little blood loss,early postoperative exhaust,and can shorten the length of hospital stay.Which is a safe and reliable therapeutic method and is worthy of clinical promotion and application.