摘要
目的对比腹腔镜与开腹行脾切除加断流术的疗效。方法选择武汉大学中南医院2014年1月至2015年12月期间住院的肝硬化门静脉高压症病人60例,均行脾切除加贲门周围血管离断术,根据手术方式不同分为两组,腹腔镜治疗组35例,开腹治疗组25例。运用统计学方法,对比两组病人手术时间、切口长度、住院时间、术中出血量、术后镇痛次数、住院费用及并发症等。结果腹腔镜组手术时间为(189.3±58.4)min,切口长度为(9.3±3.3)cm,术后平均禁食时间为(68.33±24.57)h,术中出血量为(120.3±40.4)ml,住院时间为(12.4±0.8)d,术后镇痛次数为(1.3±0.3)次,无一例术后并发症;开腹组手术时间为(203.5±61.4)min,切口长度为(22.4±5.5)cm,术后平均禁食时间为(108.25±32.48)h,术中出血量为(485.6±115.2)ml,住院时间为(15.8±1.2)d,术后镇痛次数为(2.9±0.8)次,术后并发症4例,以上指标腹腔镜组均少于开腹组(P<0.05)。但在住院费用方面腹腔镜组高于传统开腹组[(54 200.5±98.5)元比(39 985.5±120.8)元,P<0.05]。结论随着科技进步及术者水平的不断积累,腹腔镜手术适应证越来越广,腹腔镜行脾切除加断流术治疗肝硬化门静脉高压脾功能亢进创伤小,术后并发症少,具有安全性及可行性,值得在临床上推广应用。
Objective To make a comparison between laparoscopy and laparotomy combined with splenectomy and disconnection. Methods Sixty cases of liver cirrhosis with portal hypertension in our hospital from January 2014 to December 2015 were divided into two groups according to the surgi- cal procedures. All the patients were subjected to splenectomy and disconnection. Patients in the control group （25 cases） were treated with conventional laparotomy, and those in the study group （35 cases） were treated with laparoscopy. Statistically, the average operation time, the average length of incision, the average postoperative fasting time, the average amount of bleeding, the average length of hospital stay, the postoperative times of stopping pain, and incidence of complications were compared between the two groups. Results The average operation time in the study group （189.3 ± 58. 4 min） was sig- nificantly shorter than that in the control group （203.5 ± 61.4 min） （P〈0.05）. The average length of incision （9.3 ±3.3 cm）, and the average postoperative fasting time （68. 33 ± 24. 57 h） were signifi- cantly shorter in the study group than those in the control group （22. 4 ± 5. 5 cm and 108. 25 ± 32. 48 h） （P〈0. 05）. The average amount of bleeding （120. 3 - 40. 4 mL） and the average length of hospital stay （12. 4 ± 0. 8 days） were significantly reduced in the study as compared with those in the control group （485.6 ± 115. 2 mL and 15.8- 1.2 days） （P〈0. 05）. The postoperative times of stop- ping pain （1.3 ± 0. 3） were significantly less in the study group than in the control group （2. 9 ± 0. 8） （P〈0. 05）. The incidence of complications showed statistically significant difference between the con- trol group （4 cases） and study group （0 case） （P〈0. 05）. Conclusions With the development of tech- nology and surgeon＇s skills, indications of laparoscopic surgery become more and more widely. Laparo- scopic treatment of liver cirrhosis-induced portal hypertension may have a less trauma and lower inci-dence of postoperative complications. Laparoscopy is feasible and safe, and worth popularizing in clini- cal application.
出处
《腹部外科》
2017年第1期61-64,共4页
Journal of Abdominal Surgery
关键词
腹腔镜
开腹手术
脾切除加断流术
Laparoscopy
Laparotomy
Splenectomy and disconnection
