【摘要】 目的:探讨腹腔镜下改良手术和完全腹腔镜下行脾切除术联合贲门周围血管离断术的临床治疗效果分析。方法:选取2012年11月—2014年11月收治的60例门静脉高压患者作为研究对象,采取随机数字表法分为腹腔镜下改良组和完全腹腔镜组,每组各30例,腹腔镜下改良组的术式为脾切除加门奇静脉断流、食管下端吻合术,完全腹腔镜组的术式为脾切除联合贲门周围血管离断术。对比两组患者平均手术时间、术中平均出血量、术后住院总天数、并发症的发生情况以及治疗的有效情况。结果:腹腔镜下改良组的平均手术时间、术中平均出血量、术后住院总天数明显少于完全腹腔镜组,差异具有统计学意义(t=4.97,P<0.05;t=5.32,P<0.05;t=5.21,P<0.05)。腹腔镜下改良组并发症的发生率为6.67%,完全腹腔镜组并发症的发生率为30.00%,差异具有统计学意义(χ2=5.26,P<0.05)。腹腔镜下改良组的肝功能恢复率为96.67%,完全腹腔镜组的肝功能恢复率为83.33%,差异具有统计学意义(χ2=5.31,P<0.05)。结论:腹腔镜下改良手术和完全腹腔镜下行脾切除术联合贲门周围血管离断术在门静脉高压的手术治疗中均具有较好的疗效,但腹腔镜下改良手术具有手术时间短、术后恢复快及并发症少等显著优点,具有积极的临床价值,可以作为一种理想方法应用于临床工作中。更多还原

【Abstract】 Objective: To explore and analyze the modified laparoscopic surgery and the completely laparoscopic spleen resection combined with pericardial department of clinical outcomes of vascular amputation surgery. Methods: Select 60 cases of portal hypertension patients that treated in our hospital from November 2012 to November 2014 as research subjects, and patients included were divided into two groups according to the random number table, the improved laparoscopic group and the totally laparoscopic group, 30 cases in each group, the improved group accepted laparoscopic surgery for spleen resection with door azygos vein flow and lower esophagus anastomosis, the totally laparoscopic group accepted operation for spleen resection combined with pericardial devascularization surgery. Observe and compare two groups of patients for the average operation time,the mean amount of intraoperative blood loss, the postoperative total number of days of hospitalization and the effective and occurrence of complications of treatment. Results: The mean operation time, the mean amount of intraoperative blood loss and the postoperative hospital stay in the modified laparoscopic group were significantly less than the fully laparoscopic surgery group, compared with a significant difference between the two groups(t=4.97, P<0.05; t=5.32, P<0.05; t=5.21,P< 0.05). The occurrence of complications of the laparoscopic modified group was 6.67% and30.00% in the totally laparoscopic group, compared with a significant difference(χ2=5.26, P<0.05)between the two groups. The liver function recovery rate of the laparoscopic modified group was96.67% and 83.33% in the totally laparoscopic group, compared with a significant difference(χ2=5.31,P<0.05) between the two groups. Conclusion: The laparoscopic surgery and the completely modified laparoscopic spleen resection combined with pericardial Department vascular amputation surgery in portal hypertension treatment both have a good effect, but the modified laparoscopic surgery can be used as an ideal method for clinical work for its positive clinical value such as shorter operative time, postoperative faster recovery, fewer complications, and other significant advantages.更多还原