腹腔镜脾脏切除手术困难程度及风险程度预测因子的分析

Analysis of the Difficulty and Risk Factors of Laparoscopic Splenectomy

目的分析可用于术前预测腹腔镜脾脏切除手术困难程度及风险程度的相关因素。方法回顾性分析本科室2014至2015年实施的腹腔镜脾脏切除患者22例,记录手术耗时长短及术中出血量;计算体重指数(BMI)、脾脏(SPV)及全胃(STV)CT三维体积;手术耗时长短及术中出血量均分别与SPV、BMI及STV行回归分析。结果手术耗时长短与术中出血量均分别与SPV、BMI、STV呈线性相关(P<0.05);两次回归分析显示回归性均极为显著(P<0.05);与手术耗时长短的相关性大小顺序为:SPV>BMI>STV;而与术中出血量的相关性大小顺序为:SPV>STV>BMI。结论 SPV可作为术前预测腹腔镜脾切除手术困难程度及风险程度的首选因子,而STV可能为预测因素之一;BMI可能为手术困难程度预测因素,但尚不能作为手术风险预测因素。

Objective To analyze the relative factors that can be used to predict the degree of difficulty and the degree of risk of laparoscopic splenectomy. Methods We retrospectively analyzed 22 patients with laparoscopic splenectomy in our department from 2014 to 2015. The operation time and the amount of bleeding during operation were recorded. Body mass index（ BMI）,spleen（ SPV） and whole stomach（ STV） CT were calculated. Regression analysis were carried out respectively between operation time and the amount of bleeding and SPV,BMI and STV. Results Operation time and the amount of bleeding were respectively linearly correlated with SPV,BMI,STV（ P〈0. 05）. Two times of regression analysis showed that the regression was very significant（ P〈0. 05）. The order of the length of time and duration of operation was： SPVBMISTV,while the order of magnitude of the correlation with the amount of bleeding during operation was SPVSTVBMI. Conclusion SPV can be used as the first choice for predicting the difficulty and risk degree of laparoscopic splenectomy,and STV may be one of the predictors. BMI may predict the degree of surgical difficulty,but it can not be used as a predictor of surgical risk factors.