摘要
目的:探讨腹腔镜巨脾切除术的安全性、可行性、手术注意事项及并发症的防治。方法:2008年5月31日至2014年10月9日施行腹腔镜脾切除术77例,以脾脏的长径是否≥20 cm分为巨脾组(n=13)与非巨脾组(n=64)两组,并回顾同期进行的74例开腹巨脾切除术的临床资料,归为开腹组(n=74),对比三组的手术时间、术中出血量、术后恢复进食时间、术后住院时间及术后并发症发生率。结果:与非巨脾组相比,巨脾组手术时间长[(223.0±30.6)min vs.(171.9±14.2)min]、术中出血多[(360.0±57.9)ml vs.(130.8±26.2)ml]、术后住院时间长[(10.1±2.6)d vs.(7.6±0.9)d]。与开腹组相比,巨脾组术后恢复进食时间[(2.7±0.8)d vs.(4.1±0.4)d]及术后住院时间短[(10.1±2.6)d vs.(15.4±2.0)d]。结论:腹腔镜巨脾切除术是安全、可行的,并具有手术切口小、术后康复快、术后住院时间短等优点。
Objective： To explore the safety,feasibility and points for attention of laparoscopic splenectomy（ LS） for splenomegaly,and to investigate the prevention and treatment of the complications following LS for splenomegaly. Methods： From May 31,2008 to Oct. 9,2014,77 patients underwent LS. Patients with the length of the spleen greater than or equal to 20 cm were in the splenomegaly group（ n = 13） and the rest were in non-splenomegaly group（ n = 64）,and patients with splenomegaly underwent open splenectomy（ OS） in the corresponding period were in the open group. The operation time,the blood loss,the postoperative diet recovery time,postoperative hospitalization time and the rate of postoperative complications were compared among the three groups. Results： The operation time [（ 223. 0 ± 30. 6） min vs.（ 171. 9 ± 14. 2） min],postoperative hospitalization time [（ 10. 1 ± 2. 6） d vs.（ 7. 6 ± 0. 9） d] in the splenomegaly group were longer and blood loss [（ 360. 0 ± 57. 9） ml vs.（ 130. 8 ± 26. 2） ml]was more than those in the non-splenomegaly group. The postoperative diet recovery time [（ 2. 7 ± 0. 8） d vs.（ 4. 1 ± 0. 4） d] and hospitalization time [（ 10. 1 ± 2. 6） d vs.（ 15. 4 ± 2. 0） d]in the splenomegaly group were shorter than those in the open group. Conclusions： LS for splenomegaly is safe and feasible. It has advantages of small operative incision,quick postoperative recovery and short hospitalization time.
出处
《腹腔镜外科杂志》
2015年第8期565-569,共5页
Journal of Laparoscopic Surgery
基金
卫生部国家临床重点专科建设项目
福建省医学临床重点专科建设项目(编号:闽财指[2012]966号)
关键词
脾大
脾切除术
腹腔镜检查
剖腹术
疗效比较研究
Splenomegaly
Splenectomy
Laparoscopy
Laparotomy
Comparative effectiveness research
