腹腔镜下脾切除联合贲门周围血管离断术与开腹手术的临床对照的研究.pdfVIP

腹腔镜下脾切除加贲门周围血管离断术与开腹手术 的临床对照研究 研究生：江顺隆 导 师： 石铮 中文摘要 目的比较完全腹腔镜脾切除联合贲门周围血管离断术与开腹手术的近期临 床效果，并探讨完全腹腔镜的手术方法、可行性及安全性。 方法：回顾分析2006 年1 月至2010 年12 月福建医科大学附属第一医院行 完全腹腔镜与同期开腹脾切除联合贲门周围血管离断术各 34 例患者的临床资 料。 结果：腔镜组手术中2 例中转开腹，其余均成功，腹腔镜组平均手术时间稍 长于开腹组 29.3 ±12.1min ，P0.05 ；术中出血量无明显统计学差异(398.5 ± 312.5)d vs (404.4 ±241.3)d, P0.05 ；而术后排气时间提前1.3±0.3d, P0.05 ；术 后进食时间提前1.4±0.3d, P0.05 ；术后拔管时间提前3.0 ±0.5d , P0.05 ；术后 住院时间减少4.9 ±0.9d, P0.05 。术后并发症如术后出血、胰瘘、脾热、感染、 深静脉血栓等的发生率及住院费用差异无统计学意义。 结论：完全腹腔镜脾切除联合贲门周围血管离断术治疗门静脉高压症安全可 行，疗效确切，近期疗效明显优于开腹手术，值得临床推广。 关键词：腹腔镜术 贲门周围血管离断术 门脉高压症 剖腹术 病例对照研究 3 Clinical Control Study between Laparoscopic Splenectomy combined with Pericardial Devascularization and Laparotomy ABSTRACT BackgroundObjective : To compare the short-term clinical effect of laparosc -opic splenectomy combined with pericardial devascularization and laparotomy on patients suffering from portal hypertension and to explore the procedure，feasibility and safety of totally laparoscopic surgery． Methods : The clinical data of 34 cases of totally laparoscopic splenectomy comb -ined with pericardial devascularization and 34 case of laparotomy from the First Affi -liated Hospital of Fujian Medical University from Jan.2006 to June.2010 Was retrosp -ecttively analyzed． Results: Endoscopic group 2 patients converted to open surgery, others were suc -cessful ．The mean operation time was longer in the laparoscopic group than that in ． the open group(215.9±52.5)min vs (186.6±46.8)min,P0.05 There Was no significant difference between the two groups in blood loss(398.5±312.5