开腹与腹腔镜脾切除术分别联合贲门周围血管离断术治疗肝硬化门静脉高压的疗效比较

Open and laparoscopic splenectomy combined with pericardial devascularization in the treatment of cirrhotic portal hypertension

目的对比开腹与腹腔镜脾切除术分别联合贲门周围血管离断术治疗肝硬化门静脉高压的疗效。方法采用回顾性研究方法,选取2014年2月至2016年6月在我院进行诊治的肝硬化门静脉高压患者80例,根据手术方法将其分为观察组与对照组,各40例。观察组患者给予腹腔镜脾切除术联合贲门周围血管离断术治疗,对照组患者给予开腹脾切除术联合贲门周围血管离断术治疗,观察两组患者的临床效果。结果所有患者都顺利完成手术,无严重并发症发生。两组手术时间比较,无明显差异(P>0.05);但观察组患者的术中出血量、腹腔引流管放置时间明显优于对照组(P<0.05)。术后1个月,两组患者的白细胞与血小板水平都明显高于术前,且观察组的白细胞与血小板水平也明显高于对照组(P<0.05)。结论相对于开腹手术,腹腔镜脾切除术联合贲门周围血管离断术治疗肝硬化门静脉高压具有更好的微创性,能促进机体功能的恢复。

Objective To compare the clinical effect of open and laparoscopic splenectomy combined with pericardial devascularization in the treatment of cirrhotic portal hypertension. Methods A retrospective study was conducted in 80 patients with portal hypertension treated in our hospital from February 2014 to June 2016. According to the different treatment methods, patients were divided into observation group and control group, with 40 cases in each group. The observation group was treated with laparoscopic splenectomy combined with pericardial devascularization, while the control group was treated with open splenectomy combined with pericardial devascularization. The clinical effect of the two groups were observed. Results All patients were successfully completed the operation, no serious complications occurred. There was no significant difference in the operation time between the two groups（P〈0.05）; the intraoperative bleeding volume, peritoneal drainage tube placement time of the observation group were better than those of the control group（P〈0.05）. After operation for 1 month, the levels of white blood cells and platelets in the two groups were significantly higher than those before operation, and those of the observation group were better than the control group（P 0.05）. Conclusion Compared with open surgery, laparoscopic splenectomy combined with pericardial devascularization in the treatment of cirrhotic portal hypertension has a better minimally invasive, which can promote the recovery of body function.