摘要
目的:对比分析完全腹腔镜与开腹脾切除加贲门周围血管离断术治疗肝硬化门脉高压症的手术治疗效果。方法:120例研究对象均来自于2012年1月-2013年12月第四军医大学唐都医院普外科收治的肝硬化门静脉高压患者,将所有患者分为观察组与对照组,每组60例。两组患者均给予脾切除加贲门周围血管离断术,观察组在腹腔镜下操作完成,对照组传统开腹完成手术。比较两组患者术中出血量、手术及住院时间、胃肠道功能恢复时间及并发症发生情况。结果:120例患者均按分组要求顺利完成手术,手术时间比较无统计学差异(P>0.05);观察组术中出血量、术后住院时间及胃肠道恢复排气时间均优于对照组(P<0.05);术后发热、切口感染、腹腔出血积液及门静脉系统血栓等为术后常见并发症,观察组术后并发症发生率低于对照组(P<0.05)。结论:腹腔镜下脾切除+贲门周期血管离断术治疗门静脉高压症临床效果显著,安全性高,患者术后恢复快。
Objective： This study aims to compare the effect of laparoscopic and open splenectomy plus cardiac peripheral vascular disconnection in the treatment of liver cirrhosis with portal hypertension. Methods： A total of 120 patients with cirrhosis and portal hypertension were selected from January 2012 to December 2013 in Tangdu Hospital of the Fourth Military Medical University. All of them were randomly divided into the observation group （ n=60 ） and control group （n=60）. The observation group was treated by splenectomy plus cardiac peripheral vascular disconnection which used laparoscopy, and the control group was treated by traditional open surgery. The intraoperative blood loss, operation time, postoperative hospital stay, recovery time of gastrointestinal tract and occurrence of complications were compared between two groups. Results： The average operation time of observation group showed no significant difference from the control group （P〉 0.05）. However, the intraoperative blood loss, postoperative hospital stay time, recovery time of gastrointestinal tract and occurrence of complications of observation group were all better than those of the control group （P 〈0. 05）. The postoperative complications included postoperative fever, wound infection, abdominal bleeding and portal venous system thrombosis effusion, the incidence of which was obviously lower in the observation group than those of in the control group （P〈0.05）. Conclusions： Splenectomy plus cardiac peripheral vascular disconnection which used laparoscopy had significant clinical efficacy and high safety in the treatment of liver cirrhosis with portal hypertension.
作者
张雄
阴继凯
贺加星
杨林
王健
鲁建国
ZHANG Xiong YIN Ji-kai HE Jia-xing YANG Lin WANG Jian LU Jian-guo(Department of General Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi＇an, Shaanxi, 710038, China Department of General surgery, Yulin Second Hospital, Yulin, Shaanxi, 719000, China)
出处
《现代生物医学进展》
CAS
2016年第36期7140-7142,7146,共4页
Progress in Modern Biomedicine
基金
陕西省自然科学基金重点项目(2012JM4002)
关键词
腹腔镜
传统开腹
脾切除
血管离断术
门静脉高压
Laparoscopy
Traditional open surgery
Splenectomy
Vascular disconnection
Portal hypertension
