| 腹腔镜引导二级脾蒂离断切脾术在创伤性脾损伤患者中的临床效果和价值 |
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| 引用本文： | 杨燕茹,王琳,吴安琪.腹腔镜引导二级脾蒂离断切脾术在创伤性脾损伤患者中的临床效果和价值[J].中华全科医学,2021,19(1):35. |
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| 作者姓名： | 杨燕茹 王琳 吴安琪 |
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| 作者单位： | 1.空军军医大学第一附属医院外科手术室，陕西 西安 710000 |
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| 基金项目： | 陕西省重点研发计划(2018ZDXM-SF-061)。 |
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| 摘 要： | 目的 探讨与研究腹腔镜引导二级脾蒂离断切脾术在创伤性脾损伤患者中的临床效果和价值，旨在为临床治疗此类疾病提供参考依据。 方法 研究对象为空军军医大学第一附属医院2016年5月—2019年5月期间收治的创伤性脾破裂患者共54例，依据患者手术方式不同分为观察组和对照组，每组27例。对照组应用常规开腹脾切除手术治疗，观察组应用腹腔镜引导下二级脾蒂离断切脾术治疗。记录并分析2组患者平均手术时间、引流管留置时间、术中出血量、术后排气时间、平均住院时间等围手术期指标，术后短期和随访一年并发症发生情况，出院前应用本科室现行的患者满意度调查表对治疗满意度进行调查分析。 结果 观察组手术时间略长于对照组，差异有统计学意义(P＜0.05)；观察组平均出血量、引流管留置、术后排气及住院时间明显较对照组缩短，差异有统计学意义(均P＜0.05)；观察组术后短期和随访一年并发症发生率明显低于对照组患者，差异有统计学意义(均P＜0.05)；观察组治疗总满意度显著高于对照组，差异有统计学意义(P＜0.05)。 结论 创伤性脾损伤患者临床应用腹腔镜引导二级脾蒂离断切脾术治疗，与常规开腹手术治疗相比，具有较优的临床效果，不但能够大大降低术中出血量、引流时间、术后排气时间和住院时间等围手术期指标，还能减少术后短期和长期并发症发生，患者满意度高，值得在临床应用推广。
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| 关 键 词： | 创伤性脾损伤 腹腔镜 二级脾蒂离断切脾术 |
| 收稿时间： | 2020-07-11 |
Clinical effect and value of laparoscopic guided secondary spleen pedicle transection in patients with traumatic spleen injury |
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| Authors: | YANG Yan-ru WANG Lin WU An-qi |
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| Affiliation: | Surgical Operating Room, The First Affiliated Hospital of Air Force Military Medical University, Xi'an, Shaanxi 710000 |
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| Abstract: | Objective To explore the clinical effect and value of laparoscopic guided secondary spleen pedicle transection in patients with traumatic spleen injury and to provide reference for clinical treatment of this kind of disease.Methods A total of 54 cases of traumatic splenic rupture in our hospital from May 2016 to May 2019 were selected as subjects and divided into the observation group and control group on the basis of the operation mode(27 cases in each group).The control group was treated with conventional laparotomy,whereas the observation group was treated with laparoscopy-guided secondary spleen pedicle transection.The average operation time,drainage tube indwelling time,intraoperative blood loss,postoperative exhaust time,average hospital stay,the incidence of complications in the short-term and one-year follow-up were recorded and analysed.Before discharge,treatment satisfaction was analysed by the current patient satisfaction questionnaire in the undergraduate department.Results The average operation time in the observation group of perioperative indicators was longer than that in the control group.The difference was statistically significant(P<0.05).The average intraoperative blood loss,drainage tube indwelling time and postoperative exhaust time in the observation group were significantly shorter than those in the control group,which had statistically significant differences(all P<0.05).The incidence of complications in the short-term postoperative and 1 year postoperative follow-up was significantly lower in the observation group than that in the control group,which had statistically significant differences(all P<0.05).The total clinical treatment satisfaction of the observation group was higher than that of the control group,and the difference was significant(P<0.05).Conclusion Compared with conventional open surgery,traumatic splenic injury in patients with laparoscopic guided secondary spleen pedicle transection has a better clinical effect.It significantly reduces intraoperative blood loss,drainage time,postoperative exhaust time,length of hospital stay,perioperative indicators,and postoperative complications and improves patient satisfaction,which is worth popularizing in clinical application. |
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| Keywords: | Traumatic spleen injury Laparoscope secondary spleen pedicle transection |
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