脾动脉栓塞术预处理联合腹腔镜脾切除术治疗门静脉高压脾功能亢进患者的疗效评价

Clinical evaluation of Splenic Artery Embolization Pretreatment combined with laparoscopic Splenectomy in the Treatment of Portal Hypertension and Hypersplenism

目的探讨脾动脉栓塞术(SAE)预处理联合腹腔镜脾切除术(LS)治疗门静脉高压脾功能亢进患者的效果及安全性。方法选取河南省安阳市第五人民医院2017年9月至2020年4月收治的68例门静脉高压脾功能亢进患者为研究对象,以随机数表法分为研究组与对照组,各34例。研究组采取SAE预处理联合LS治疗,对照组仅采取LS治疗。统计两组手术情况、并发症发生情况。结果研究组手术时间、住院时间短于对照组,术中失血量少于对照组,中转开腹率低于对照组,差异均有统计学意义(P<0.05);两组术后进食时间、肠道功能恢复时间、术后下地活动时间比较,差异无统计学意义(P>0.05)。两组均无切口感染、出血、胰漏、肺不张等并发症,研究组并发症总发生率(8.82%)低于对照组(14.71%),但差异无统计学意义(P>0.05)。结论联合采取SAE预处理及LS治疗门静脉高压脾功能亢进效果显著,且安全性高。

Objective To evaluate the efficacy and safety of splenic artery embolization(SAE)combined with laparoscopic splenectomy(LS)in the treatment of portal hypertension hypersplenism.Methods A total of 68 patients with hypersplenism were enrolled from September 2017 to April 2020 in the Fifth People's Hospital of Anyang,Henan Province.The patients were randomly divided into study group and control group with 34 cases in each group.SAE pretreatment combined with LS was used in study group,and only LS was used in control group.The operation and complications of the two groups were analyzed.Results The operation time and hospitalization time of the study group were shorter than that of the control group,the blood loss during operation was less than that of the control group,the conversion rate was lower than that of the control group,the difference was statistically significant(P<0.05);There was no significant difference between the two groups in feeding time,intestinal function recovery time and movement time after operation(P>0.05).No complications such as wound infection,bleeding,pancreatic leakage and atelectasis were found in the two groups.The total incidence of complications in the study group(8.82%)was lower than that in the control group(14.71%),but there was no significant difference(P>0.05).Conclusion SAE preconditioning combined with LS is effective and safe in the treatment of portal hypertension and hypersplenism,the safety is high.