严重粘连性巨脾外科手术临床分析.pdfVIP

临床研究 2012 年 6 月第 9 卷第 16 期 严重粘连性巨脾外科手术临床分析 牛 磊 王春喜 朱丽文 解放军 总医院普外科 军 医进修学 院,北京 100853 [摘要] 目的 总结严重粘连性巨脾切除术的治疗方法 O 方法 对 1998 年 1 月2010 年 12 月我院收治的 59 例严重粘 连性巨大脾脏患者切除术 分析术前 相关 资料 ~术中病 理解剖 特点 ~特殊 处理措施 ~术后并发症的 处理 以及临床疗 效 O 结果 59 例均 获得 临床痊愈 无 围术期死亡及胃 ~肠 道 穿孔等严重 损 伤 其中 15 例术后出现肺 部 感染 ~肺 不张 ~ 腹水以及脾静脉血栓性静脉炎 等 发生率 为 25.4% O 结论 充 分的术前评估 规范 的手术操作 仔 细的脾周粘连组织 分 离 以及脾蒂 的正确离断 是 确保严重粘连性巨大脾脏切除的 关键 O [关键词] 巨大脾脏脾切除 门静脉高压症 [ 中图分类号] R657.6 [文献标识码] A [文章编号] 1673-7210 2012 06 a -0066-03 The clinical analysis of surgical treatment of severe adhesive megalosplenia NIU Lei WANG Chunxi ZHU Liwen Department of Generai Surgery, Ciinicai Division of Surgery, the Chinese Generai PLA ~ospitai, Beijing 100853, China [abstract] Objective To smmarize the operative treatments of 59 cases with severe adhesive megaiospienia. Methods Ac cording to the 59 operated cases of severe adhesive megaiospienia cases were coiiected in our hospitai from January 1998 to December 2010, the preoperative information, pathoiogicai features, speciai measures of intraoperative, the treatment of Postoperative compiications and the ciinicai efficacy were retrospectiveiy anaiyzed. Results The 59 cases were aii ciinicaiiy cured without any death or serious compiications such as gastrointestinai perforation, etc. The 15 of 59 cases were occurred miid compiication (uimonary infection, ateiectasis, ascite and spienic phiebothrombosis), which occupied 25.4% of the 59 cas es. Conclusion The carefui evaiuation before operation, standardized operative procedure, reasonabie, effective dissection of perispienic adhesion and the spienic peduncuiar cut, are the key roies to ensure