腹腔镜脾切除加贲门周围血管离断术治疗门脉高压症及术中护理配合.docVIP

精品论文 参考文献 腹腔镜脾切除加贲门周围血管离断术治疗门脉高压症及术中护理配合 杨永红 黄嘉（通讯作者） 杨华梅 　　(重庆黔江中心医院 重庆黔江 409099) 　　【摘要】目的：探讨全腹腔镜下脾切除加贲门周围血管离断术（LSPD）治疗门脉高压的临床应用及护理配合规范。方法：回顾2010年1月—2013年2月间20例全腹腔镜脾切除加贲门周围血管离断术的临床资料，分析术中出血量、手术时间和术后并发症发生率。结果：在规范，准确的医护配合操作下，20例均在全腔镜下完成，手术时间180~430min，平均(265plusmn;42) min。术中失血150~1050 ml，平均(450plusmn;240)m1。术后发生胸腔积液3例，门静脉血栓l例；低-中度发热2例，无术中及围手术期死亡。术后住院8~14d，平均(8.5plusmn;4.0)d。结论：熟练规范的操作使得LSPD更加安全、可行，良好的护理配合可提高手术效率，缩短手术时间。 　　【关键词】腹腔镜手术 贲门周围血管离断术 门脉高压症 护理配合 　　【中图分类号】R472.3 【文献标识码】A 【文章编号】1672-5085（2014）10-0094-02 　　Laparoscopic Splenectomy Pericardial Devascularization for Treatment of Portal Hypertension and Nursing Cooperation 　　Yang Yong-hong .HuangJia.Yang Hua-mei 　　 Qian jiang Central Hospital of Chong Qing city, Qian jiang 409000 　　【Abstract】objective To Explore Clinical effects of the full laparoscopic splenectomy and pericardial devascularization(LSPD) with Standardized nurse cooperation for portal hypertension. Methods: Retrospective analysis ofclinical databetweenJanuaryebruary20 cases of laparoscopic splenectomy pericardial Devascularization, analyze blood loss, operative time and postoperative complication rate. Results: With Standardized nurse cooperation, 20 cases were completed in full endoscopic, surgical time 180~ 430min, average (265 plusmn; 42) min. Intraoperative blood loss 150 ~ 1050 ml, average (450 plusmn; 240) m1. 3 cases of postoperative pleural effusion, l case of portal vein thrombosis ; 2 cases of low - moderate fever , no intraoperative and perioperative mortality. Postoperative hospital stay was 8 ~ 14d, the average (8.5 plusmn;4.0) d. Conclusions: The LSPD is a safe, minimally invasive surgical approach for portal hypertension, with standardized nurse cooperation can improve surgical efficiency and shorten the operation time. 　　【Key words】Laparoscopy Pericardial devascularization Portal hyperten8ion Nursing cooperation 　　目前对于门脉高压的治疗手段最常用的是脾切除加贲门周围血管离断术[1]。随着腹腔镜技术的