门静脉高压症患者脾切除术后常见并发症的分析.pdfVIP

腹部外科 2013 年第 26 卷第 1 期 Fu Bu Wai Ke. Feb. 2013. Vo l. 26. No.l • 49 • ·临床实践· 门静脉高压症患者脾切除术后 常见并发症的分析 潘定宇毛晓雯熊良昆李昌盛孔雕雕刘志苏 E摘要】 目的 总结门静脉高压症患者脾切除术后常见并发症的防治经验。方法 对 2006~ 2011 年 256 例施行脾切除术的门静脉高压症患者资料进行回顾性分析。结果 256 例脾切除术后 1 个月内出现并发症共38 例(14.84% )，其中以腹腔内大出血、腹腔积液及门静脉血栓形成的发生率较 高。死亡7 例(2.73%) .死亡原因为腹腔内大出血、肝衰竭及多器官功能衰竭。结论 有效的围手术 期处理对于降低脾切除术后并发症发生率及死亡率极为重要。 E关键词】 高血压，门静脉;脾切除术;手术后并发症;围手术期处理 Analysis of 阴施toperative complications after splenectomy in patients with 归，rta) hypentension PAN Ding-yu. MA.O Xiao-四n ， XIONG Liang-ku , et al. Deρartment 0/ Hepatobiliary and Pancreatic Surgery , Zhongnan Hosρital. Wuhan University , Wuhan 430071 , China Corre吵onding author: LIU Zhi→剿 ， E-mail: 362046240 曲 [Abstractl Objective To summarize the prophylaxis and treatment of postoperative complica tions after splenectomy in patients with portal hypentension. Method国 We reviewed the results of 256 patients with portal hypentension who underwent the splenectomy from 2006 to 201 1. Results Post operative complications occurred in 38 of all the patients (14.84%). The top three of the complica tions were intraabdominal m且ssive bleeding , massive ascites and portal vein thrombosis. The operative mortality was 2.73% (7/256). The main causes of death included intraabdominal massive bleeding , liver failure and multiple organ dysfunction syndrome. Conclusioo Effectively perioperative manage- ment is very important for reducing the incidence of complications and the mortality. [Key w制咀sl Hypertension portal; Splenectomy; Postoperative complication; Perioperative man- agement 1910 年 Mayo 报告脾切除术[1] ，距今已有 100 例，择期手术 230 例。手术方式为牌切除术联合责 门血管离断术 190 例，单纯脾切除术 66 例。 多年历史了。脾切除术是我国治疗门静脉高压症的