脾切除贲门周围血管离断术治疗肝硬化门脉高压症的疗效及对患者肝功能指标的影响

摘要

Objective:To explore the effect of splenectomy and pericardial devascularization in the treat-ment of portal hypertension with liver cirrhosis and its effect on liver function in patients. Methods:A total of 78 patients with portal hypertension were treated in our hospital from March 2016 to May 2017.All the patients were divided into two groups according to random number table, each group of 39 cases. The patients in the control group were treated with traditional open splenectomy and pericardial devascularization.And the patients in the observation group were treated with laparoscopic splenectomy and pericardial devascularization. The clinical indicators,liver function indexes and complications were compared between the two groups. Results:The intraoperative blood loss,visual analogue scale(VAS) score,bowel function recovery time and hospitali-zation time were less in the observation group,and the operation time was longer and the difference was statis-tically significant(P <0.05).There was no significant difference in the levels of prothrombin time(PT),albu-min(ALB),alanine aminotransferase(ALT) and total bilirubin(TBIL) between the two groups before oper-ation (P> 0.05).The levels of PT,ALB,ALT and TBIL in the two groups were significantly better than those before operation (P <0.05).The levels of PT,ALT and TBIL in the observation group were significantly high-er than those in the control group,the ALB level was lower(P <0.05).The incidence of postoperative compli-cations was 5.13% (2/39) in the observation group significantly higher than that in the control group (23. 08%,9/39),the difference was statistically significant (P <0.05). Conclusion: Laparoscopic resection of pericardial cardiomyocytes can reduce the amount of intraoperative blood loss,reduce the incidence of compli-cations,shorten the recovery time and hospital stay in patients with cirrhotic portal hypertension,improve liver function.%目的:探讨分析脾切除贲门周围血管离断术治疗肝硬化门脉高压症的疗效及对患者肝功能指标的影响.方法:选取2016年3月至2017年5月在我院进行治疗的肝硬化门脉高压症患者78例作为研究对象,按随机数表法分为两组,各39例.对照组行传统开腹脾切除贲门周围血管离断术,观察组予腹腔镜脾切除贲门周围血管离断术,比较两组临床相关指标、肝功能指标及并发症情况.结果:观察组术中出血量、视觉模拟评分法(VAS)评分、肠功能恢复时间及住院时间均较少,手术时间较长,差异有统计学意义(P<0.05);术前,两组凝血酶原时间(PT)、白蛋白(ALB)、丙氨酸氨基转移酶(ALT)、总胆红素(TBIL)水平比较,差异无统计学意义(P>0.05);两组术后 PT、ALB、ALT、TBIL 水平均明显优于术前,差异有统计学意义(P<0.05);术后,观察组 PT、ALT 及 TBIL 水平均明显高于对照组,ALB 水平较低,差异有统计学意义(P<0.05);观察组术后并发症发生率5.13%(2/39)明显高于对照组的23.08%(9/39),差异有统计学意义(P<0.05).结论:腹腔镜脾切除贲门周围血管离断术可减少肝硬化门脉高压症患者术中出血量,减少并发症发生,缩短肠功能恢复时间及住院时间,改善患者肝功能.