完全腹腔镜脾切除手术方法及临床经验总结.docVIP

精品论文 参考文献 完全腹腔镜脾切除手术方法及临床经验总结 湖南省郴州市第一人民医院 423000 摘要：目的：研究并探讨完全腹腔镜脾切除手术方法，并总结其临床经验。方法：选取22例完全腹腔镜脾切除手术患者作为研究对象，选取自2012年7月～2015年9月。对这22例患者的临床资料进行回顾性的分析总结，观察患者手术情况和术后转归情况。结果：22例患者的手术均取得成功，有15例患者经完全腹腔镜脾切除，2例腹腔镜下手辅助脾切除，4例中转为开腹脾切除手术，1例患者被诊断为脾结核。22例患者的手术时间为154~370min，平均为（197.42plusmn;52.89）min；术中出血量为50~800ml，平均为（213.65plusmn;27.32）ml；术后住院7~22天，平均12.3天；有6例患者在手术中使用强生EC60A直线切割吻合器。22例患者均痊愈出院，未出现并发症。结论：完全腹腔镜脾切除术的手术效果显著，具有较高的安全性，适用于大部分的脾脏疾病的临床治疗中，该种手术方法的关键在于如何正确处理脾门和脾蒂，在手术过程中，应根据患者的具体情况对脾门、脾蒂进行处理。若脾脏巨大操作困难或有较多出血，可转手辅助脾切除，最后转行开腹脾切除手术，以保证手术安全。 关键词：完全腹腔镜脾切除术；手术方法；临床经验 Abstract：Objective：To study and explore the methods of total laparoscopic splenectomy and summarize the clinical experience.Methods：22 cases of total laparoscopic splenectomy were selected as the research object，from September 2015 to July 2012.The clinical data of 22 patients were analyzed retrospectively，and the operation conditions and prognosis of the patients were observed.Results：all of the 22 cases were successful，15 patients underwent complete laparoscopic splenectomy，2 cases of laparoscopic splenectomy，4 cases converted to open operation，1 cases were diagnosed as splenic tuberculosis.22 cases of patients with operation time for 154~370min average（197.42 + 52.89）min；intraoperative hemorrhage volume for 50~800ml average（213.65 + 27.32）ml；postoperative hospital 7 days，with an average of 12.3 days，6 patients during surgery using Johnson amp; Johnson EC60A linear cutting stapling device.22 patients were cured and discharged without complications.Conclusion：totally laparoscopic splenectomy operation effect significantly，with high safety，suitable for the clinical treatment of most of the diseases of the spleen and the operative methods of key is how to correctly handle the hilum of the spleen and splenic pedicle，in operation process，should according to the specific circumstances of the patient to the hilum of spleen，splenic pedicle for processing.If huge splenic operation difficult or more bleeding，hands