旋切法取脾在肝硬化腹腔镜脾切除术中的应用

摘要

Objective:The application of rotation cutting method in laparoscopic splenectomy for splenomegaly with cirrhosis of the liver was investigated.Methods :A total of 69 cases of splenomegaly with cirrhosis of the liver diagnosed by imaging were included in the study. 36 patients were treated with rotation cutting method (B group),and 33 patients were treated with traditional small incision method (A group).All the patients were followed up for 3 months after operation.The outcomes of patients in B group and A group were compared. Results:The operation time and anesthesia time was longer in B group than in A group.There was no significant difference in postoperative hospital stay,spleen weight (kg),spleen remnant rate,blood loss (ml),postoperative blood ammonia,live function,hepatic encephalopathy rate,and mortality between two groups.Conclusion:Rotation cutting method is safe and effective in the laparoscopic splenectomy of splenomegaly with cirrhosis of the liver patients.%目的:探讨旋切法取脾标本用于肝硬化伴脾肿大患者围手术期的安全性和优越性.方法:回顾性分析经影像学检查证实为肝硬化伴脾肿大患者69例,均接受择期腹腔镜脾切除术.其中36例患者旋切法取脾作为B组,其余33例采用小切口大块取脾作为A组,采用临床对照研究,随访至术后3个月.结果:B组较对照A组手术时间、麻醉时间延长,差异有统计学意义(P<0.05);两组术后住院时间差异无统计学意义(P>0.05);两组术中脾重量、脾组织残留率、术中出血量、术后血氨、肝功能指标、肝性脑病和病死率差异无统计学意义(P>0.05).结论:应用旋切法取脾标本是安全、有效,且更符合美观及切口微小的患方心理需求.