摘要
目的:比较腹腔镜脾切除术和开腹脾切除术治疗创伤性脾破裂(TSR)的效果及安全性。方法:选择2022年1月—2024年6月于新余市人民医院手术治疗的80例TSR患者作为研究对象,随机分为观察组和对照组,各40例。对照组行开腹脾切除术治疗,观察组采用腹腔镜脾切除术治疗。比较两组术中指标、术后恢复情况、并发症发生率、VAS评分、PLT和免疫功能变化情况。结果:相较于对照组,观察组脾动脉阻断时间、术后排气时间、术中出血量、胃管拔除时间、腹腔引流时间、住院时间及术后并发症发生率均更优,而观察组手术时间较对照组更长(P<0.05);观察组术后1、2、3 d VAS评分均低于对照组(P<0.05);术后3 d,两组CD4^(+)、CD4^(+)/CD8^(+)水平均较术前降低,且相较于对照组,观察组CD4^(+)、CD4^(+)/CD8^(+)水平均更高(P<0.05);术后3 d,两组PLT、CD8^(+)水平均较术前升高,且相较于对照组,观察组PLT、CD8^(+)水平均更低(P<0.05)。结论:相较于开腹脾切除术,腹腔镜脾切除术治疗TSR患者的效果更好,可有效缩短术后康复时间,缓解患者不适,保护免疫功能及改善预后。
Objective:To compare the effects and safety of laparoscopic splenectomy and open splenectomy in the treatment of traumatic splenic rupture(TSR).Method:A total of 80 patients with TSR who underwent surgical treatment at Xinyu People's Hospital from January 2022 to June 2024 were selected as the research subjects and randomly divided into observation group and control group,with 40 cases in each group.The control group was treated with open splenectomy,while the observation group was treated with laparoscopic splenectomy.The intraoperative indicators,postoperative recovery conditions,incidence of complications,VAS scores,PLT and changes in immune function of the two groups were compared.Result:Compared with the control group,the splenic artery occlusion time,postoperative exhaust time,intraoperative blood loss,gastric tube removal time,abdominal drainage time,hospital stay,and incidence of postoperative complications in the observation group were better,while the operation time in the observation group was longer than that in the control group(P<0.05).Compared with the control group,the VAS scores of the observation group at 1,2 and 3 d after surgery were lower(P<0.05).At 3 days postoperatively,the levels of CD4^(+)and CD4^(+)/CD8^(+)in both groups were lower than those before surgery,and those in the observation group were higher than those in the control group(P<0.05).At 3 days after surgery,the levels of PLT and CD8^(+)in the two groups were higher than those before surgery,and those in the observation group were lower than those in the control group(P<0.05).Conclusion:Compared with open splenectomy,laparoscopic splenectomy has a better effect in the treatment of TSR,which can effectively shorten the postoperative recovery time,alleviate the discomfort of patients,protect the immune function and improve the prognosis.
作者
胡云
杨锴
林建平
HU Yun;YANG Kai;LIN Jianping(Trauma Emergency Center of Xinyu People's Hospital,Xinyu 338000,China;不详)
出处
《中国医学创新》
2025年第35期89-93,共5页
Medical Innovation of China
基金
新余市科技计划项目(20223090898)。
关键词
创伤性脾破裂
脾切除术
腹腔镜
免疫功能
并发症
Traumatic splenic rupture
Splenectomy
Laparoscopic
Immune function
Complications
