完全腹腔镜脾切除加贲门周围血管离断术治疗肝硬化门静脉高压症效果分析

Effect analysis of complete laparoscopic splenectomy combined with pericardial devascularization in the treatment of cirrhosis portal hypertension

目的 评价完全腹腔镜脾切除加贲门周围血管离断术治疗肝硬化门静脉高压症患者的临床效果。方法 选择2011年10月~2015年9月我院收治的66例确诊为肝硬化门静脉高压症并上消化道出血患者作为研究对象,根据治疗方法的不同分观察组（n=32）和对照组（n=34）,对照组患者采用传统脾切除联合贲门周围血管离断术,观察组观察采用完全腹腔镜脾切除加贲门周围血管离断术,比较两种手术方式的临床疗效。结果 观察组术中出血量、术后引流量、总住院费用、并发症发生率与对照组比较,差异无统计学意义（P〉0.05）;观察组术后肛门排气时间、术后住院时间均明显短于对照组（P〈0.05）;观察组手术时间明显比对照组长,差异有统计学意义（P〈0.01）。观察组切口长度、禁食时间、术后镇痛次数均明显少于对照组,差异有统计学意义（P〈0.05）。结论 完全腹腔镜脾切除加贲门周围血管离断术治疗肝硬化门静脉高压症是安全可行的手术方式。

Objective To evaluate clinical efficacy of complete laparoscopic splenectomy combined with pericardial devaseularization in the treatment of cirrhotic portal hypertension.Methods 66 patients with cirrhotic portal hyperten- sion combined with upper gastrointestinal bleeding who were diagnosed and admitted into our hospital from October 2011 to September 2015 were selected as research subjects and divided into observation group （n=32） and control group （n=34） according to different therapeutic methods.Patients in the control group were given were given convention- al splenectomy combined with pericardial devascularization,while patients in the observation group were treated with complete laparoscopic splenectomy combined with pericardial devascularization.Clinical curative effects between two groups were compared.Results There were no significant differences between two groups in the ＂intraoperative blood loss,postoperative drainage volume,total hospitalization cost and postoperative complication rate （P〉0.05）;postoperative anal exhaust time and postoperative hospital stay in the observation group was significantly shorter than that in the control group （P〈O.OS）;operation time of the observation group was significantly longer than that of the control group, and the difference was statistically significant （P〈0.01）.There were significant differences in incision length,fasting time and postoperative analgesia times between two groups （P〈0.05）.Conclusion Complete laparoscopic splenectomy combined with pericardial devascularization in the treatment of cirrhosis portal hypertension is a safe and feasible surgical procedure.