Objective To compare clinical efficacy between the situ secondary spleen pedicle amputation in laparoscopic splenectomy and open splenectomy for traumatic spleen rupture.Methods From January 2013 to June 2015 a total of 70 patients with splenic rupture undergoing splenectomy were devided into laparoscopic surgery (35 cases) and open surgery (35 cases) group.Clinical data included total intraoperative blood loss,the time spent on splenic artery ligation,total operation time,postoperative drainage volume,postoperative hemoglobin,platelet and albumin levels,time of anal exsufflation,hospital stay and postoperative complications.Results The average operation time in the OS group was shorter than that in LS group (P ＜ 0.05).However,LS group was better than the OS group in splenic artery ligation time,postoperative drainage volume,anus aerofluxus time,postoperative platelet count,postoperative albumin recovery,hospital stay and postoperative complications (all P ＜ 0.05).Conclusions The laparoscopic splenectomy by the amputation of in situ secondary spleen pedicle for traumatic spleen rupture has the advantages of a rapid recovery and a low postoperative complication.%目的 探讨腹腔镜下二级脾蒂离断切脾术与开腹脾切除术治疗创伤性脾破裂的临床效果.方法 回顾性分析海宁市中心医院2013年1月至2015年6月因创伤性脾破裂行脾切除术的70例患者临床资料,其中腹腔镜下二级脾蒂离断脾切除手术及开腹脾切除手术各35例.比较2组患者的术中总出血量,脾动脉结扎时间及总手术时间,术后引流量,术后血红蛋白、血小板及白蛋白变化情况,肛门通气时间,住院时间,并发症发生率等指标.结果 开腹组平均手术时间短于腔镜组,差异有统计学意义(P＜0.05),腔镜组在脾动脉结扎时间、术后引流量、术后肛门排气时间、术后血小板峰值、白蛋白恢复情况、住院时间及并发症发生率等方面均优于开腹组,差异有统计学意义(P＜0.05).结论 腹腔镜下原位二级脾蒂离断法脾切除术治疗外伤性脾破裂具有恢复快,并发症发生率低的优势,安全可行.
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