摘要
目的探讨腹腔镜与开腹手术治疗肝硬化门静脉高压及脾功能亢进的疗效。方法选取60例肝硬化门静脉高压及脾功能亢进患者,随机分为两组,对照组(30例)采用开腹脾切除手术,观察组(30例)采用腹腔镜脾切除手术,观察记录两组手术情况,术后12 h,24 h和48 h的VAS评分以及血象变化,评价腹腔镜与开腹手术治疗肝硬化门静脉高压及脾功能亢进的疗效。结果两组术中出血量及术后切口感染发生率相比,无统计学差异(P>0.05)。观察组手术时间明显长于对照组,而切口长度、住院时间和肠道功能恢复时间均显著短于对照组(P<0.05)。观察组术后12 h、24 h和48 h的VAS评分均明显低于对照组(P<0.05)。观察组术后镇痛次数明显少于对照组(P<0.05)。术前两组WBC、RBC、Hb和PLT水平相比,无统计学差异(P>0.05),术后WBC、RBC、Hb和PLT水平均明显提高(P<0.05),组间比较无统计学差异(P>0.05)。结论腹腔镜脾脏切除术治疗肝硬化门静脉高压及脾功能亢进,能使恢复患者正常血象,提高肠道功能恢复速度,术后疼痛较轻,患者出院时间较早,值得临床推广使用。
Objective To explore theefficacy of laparoscopic splenectomyintreatment of hypersplenism secondary to liver cirrhosis with portal hypertension. Methods Sixty patients with hypersplenism secondary to liver cirrhosis and portal hypertension were selected and divided into two groups randomly. There were 30 pa-tients who underwent laparoscopic splenectomy as an observation group and 30 patients with open splenecto-my as a control group. Perioperative variables, VAS scores at 12, 24 and 48 hours and complete blood counts were compared. Results The intraoperative blood loss and incidence of postoperative wound infection had no significant difference between two groups （P 〉 0.05）. The operation time of observation group was obvious longer than control group, while the length ofhospital stays, length o f surgical incision, recovery time ofbowel function in observation group were shorter than those in control group （P 〈 0.05）. Observation group had lower VAS score than control group at 12, 24 and 48 hours after surgery（P 〈 0.05）. Observation group required less postoperative analgesia compared to control group （P 〈 0.05）. The blood counts including WBC, RBC, Hb and PLT were significantly increased after surgery in both two groups （ P 〈 0.05）, however, there were no signifi-cant differences between two groups （ P 〉 0.05）. Conclusion Laparoscopic splenectomy can be widely used for the treatment of patients with portal hypertension and hypersplenism. It may improve hematological abnor-malities with an earlier recovery of bowel function and shorter hospital stay as well as less postoperative pain.
出处
《现代消化及介入诊疗》
2017年第4期460-463,共4页
Modern Interventional Diagnosis and Treatment in Gastroenterology
关键词
腹腔镜
开腹手术
门静脉高压
脾功能亢进
Laparoscopic
Open splenectomy
Portal hypertension
Hypersplenism
