手助腹腔镜与开腹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比较

摘要

Objective To compare the clinical effect and safety of hand-assisted laparoscopic and open splenectomy combined with pericardial devascularization for the treatment of portal hypertension in liver cirrhosis.Methods 86 liver cirrhosis cases ready to take operation were selected between February 2012 and July 2015, and divided into research group and control group according to operation method, the patients of research group ready to take hand-assisted laparoscopic splenectomy combined with pericardial devascularization, while control group would be taken open surgery,while at the same time, 38 intrahepatic duct cases which were taken open splenectomy combined with pericardial devascularization were selected into control group.The clinical effect and complications of two groups were compared.Results The operation time, bleeding volume, postoperative drainage volume and postoperative hospitalization time of two groups were conducted, the difference was statistically significant (P＜0.05), in which operative time of research group was more than that of control group, and postoperative drainage volume and postoperative hospitalization time of research group were less than these in control group.The incidence of pulmonary infection, peritoneal effusion and incision infection in research group were lower than these in control group, the difference was statistically significant (P＜0.05).Conclusion Hand-assisted laparoscopic combined pericardial devascularization for the treatment of cirrhosis patients with portal hypertension has characteristic of good clinical effect, less complications, and it has important reference value in clinical.%目的 比较手助腹腔镜与开腹脾切除贲门周围血管离断术治疗肝硬化门脉高压症疗效及安全性分析.方法 选取2012年2月至2015年7月肝硬化门脉高压症患者86例,根据手术方法分为观察组(n=52例)和对照组(n=34例),其中观察组采用手助腹腔镜脾切除联合贲门周围血管离断术治疗,对照组采用开腹脾切除贲门周围血管离断术治疗.比较两组患者手术效果及术后并发症发生情况.结果 观察组患者术中出血量、术后住院时间和术后引流量等均明显小于对照组,差异有统计学意义(P＜0.05),观察组手术时间明显长于对照组,差异有统计学意义(P＜0.05).观察组肺部感染、腹腔积液及切口感染等并发症发生率均明显低于对照组,差异有统计学意义(P＜0.05).结论 手助腹腔镜脾切除联合贲门周围血管离断术治疗肝硬化门脉高压症,具有术后康复快、手术创伤小、术后并发症少等优点,可明显降低复杂腹腔镜手术的风险和难度,可明显提高安全性和手术疗效,值得临床推广.