腹腔镜与开腹脾切除贲门周围血管离断术治疗肝硬化门静脉高压脾肿大的临床对比(1)
摘要：目的 比较腹腔镜和开腹脾切除断流术治疗肝硬化门脉高压症的近期临床效果。方法 选取我院2016年1月～2017年12月肝硬化门脉高压患者57例，随机分为腹腔镜组和开腹组。腹腔镜组30例采用腹腔镜脾切除断流术治疗，开腹组27例采用开腹脾切除断流术治疗。对比两组患者的手术时间、术中出血量、引流量、排气时间、术后肝功能分级、术后并发症发生率、住院时间和住院总费用。结果 腹腔镜组的手术时间长于开腹组[(187.56±27.43)min vs(153.82±45.19)min]，腹腔镜组术中出血量[(320.85±158.65)ml vs(430.25±202.16)ml]、术后腹腔引流量[(780.65±235.43)ml vs(1225.45±189.35)ml]和住院时间[(7.55±3.25)d vs(10.57±4.37)d]均低于开腹组，腹腔镜组术后并发症发生率低于开腹组(16.67% vs 25.93%)，差异均有统计学意义(P<0.05)。两组患者术后肝功能分级和住院总费用相比，差异无统计学意义(P>0.05)。结论 腹腔镜脾切除断流术安全可行，其近期临床效果较传统开腹手术具有恢复快、并发症少等优势，具有微创手术的优越性。
, 百拇医药
关键词：腹腔镜;脾切除术;断流术;门静脉高压
中图分类号：R657.34 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.01.033
文章編号：1006-1959(2019)01-0109-03
Clinical Comparison of Laparoscopic and Open Spleen Resection of the Pericardium in the Treatment of Cirrhosis with Portal Hypertension and Splenomegaly
WANG Xiang-xiang，LIU Ming-zhong，YANG Zhong-qiu，ZHANG Xing-diao，LIU Hong
, 百拇医药
(Department of Hepatobiliary Surgery，Dazhou Central Hospital，Dazhou635000，Sichuan，China)
Abstract：Objective To compare the recent clinical effects of laparoscopic splenectomy and disconnection in the treatment of cirrhotic portal hypertension. Methods 57 patients with portal hypertension from January 2016 to December 2017 were randomly divided into laparoscopic group and open group. Laparoscopic splenectomy and disconnection were performed in 30 cases in laparoscopic group and 27 cases in laparotomy group. The operative time， intraoperative blood loss， drainage flow， exhaust time， postoperative liver function grading， postoperative complications， hospital stay and total hospitalization cost were compared between the two groups. Results The operation time of the laparoscopic group was longer than that of the open group [(187.56±27.43) min vs (153.82±45.19) min]， and the amount of bleeding in the laparoscopic group [(320.85±158.65) ml vs (430.25±202.16) ml]， surgery Posterior abdominal drainage [(780.65±235.43) ml vs (1225.45±189.35) ml] and hospitalization time [(7.55±3.25) d vs (10.57±4.37) d] were lower than the open group， and the laparoscopic group was concurrent The incidence of symptoms was lower than that of the open group (16.67% vs 25.93%)，the difference was statistically significant (P<0.05). There was no significant difference in postoperative liver function grading and total hospitalization cost between the two groups (P>0.05). Conclusion Laparoscopic splenectomy is safe and feasible. Its recent clinical effect has the advantages of faster recovery and less complications than traditional open surgery. It has the superiority of minimally invasive surgery., 百拇医药(王翔翔 刘明忠 杨中秋 张兴雕 刘洪)
, 百拇医药
关键词：腹腔镜;脾切除术;断流术;门静脉高压
中图分类号：R657.34 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.01.033
文章編号：1006-1959(2019)01-0109-03
Clinical Comparison of Laparoscopic and Open Spleen Resection of the Pericardium in the Treatment of Cirrhosis with Portal Hypertension and Splenomegaly
WANG Xiang-xiang，LIU Ming-zhong，YANG Zhong-qiu，ZHANG Xing-diao，LIU Hong
, 百拇医药
(Department of Hepatobiliary Surgery，Dazhou Central Hospital，Dazhou635000，Sichuan，China)
Abstract：Objective To compare the recent clinical effects of laparoscopic splenectomy and disconnection in the treatment of cirrhotic portal hypertension. Methods 57 patients with portal hypertension from January 2016 to December 2017 were randomly divided into laparoscopic group and open group. Laparoscopic splenectomy and disconnection were performed in 30 cases in laparoscopic group and 27 cases in laparotomy group. The operative time， intraoperative blood loss， drainage flow， exhaust time， postoperative liver function grading， postoperative complications， hospital stay and total hospitalization cost were compared between the two groups. Results The operation time of the laparoscopic group was longer than that of the open group [(187.56±27.43) min vs (153.82±45.19) min]， and the amount of bleeding in the laparoscopic group [(320.85±158.65) ml vs (430.25±202.16) ml]， surgery Posterior abdominal drainage [(780.65±235.43) ml vs (1225.45±189.35) ml] and hospitalization time [(7.55±3.25) d vs (10.57±4.37) d] were lower than the open group， and the laparoscopic group was concurrent The incidence of symptoms was lower than that of the open group (16.67% vs 25.93%)，the difference was statistically significant (P<0.05). There was no significant difference in postoperative liver function grading and total hospitalization cost between the two groups (P>0.05). Conclusion Laparoscopic splenectomy is safe and feasible. Its recent clinical effect has the advantages of faster recovery and less complications than traditional open surgery. It has the superiority of minimally invasive surgery., 百拇医药(王翔翔 刘明忠 杨中秋 张兴雕 刘洪)