腹腔镜下门奇静脉断流加脾切除术效果观察

目的探讨腹腔镜下脾切除+门奇静脉断流术治疗肝硬化门静脉高压症的效果。方法选取65例2013-06-2015-06间收治的肝硬化门静脉高压症患者,根据手术方式的不同分为2组。腔镜组36例采用腹腔镜下门奇静脉断流术+脾切除术,开腹组29例采用传统开腹手术。比较2组治疗效果。结果 65例均成功手术。腔镜组手术时间长于开腹组,术中出血量、术后下床时间、平均排气时间、住院时间及术后并发症发生率均少于或短于对照组,差异均有统计学意义(P0.05)。结论腹腔镜下门奇静脉断流术+脾切除治疗肝硬化门静脉高压症,近期疗效优于传统开腹手术。

Clinical effect of laparoscopic portal azygous vein disconnection combined with splenectomy and conventional op-eration

Objective To study the clinical effect of laparoscopic splenectomy combined with portal azygous vein disconnection and conventional laparotomy in the treatment of portal hypertension. Methods Totally 65 patients with portal hypertension treated from June 2013 to June 2015 in our hospital were selected. The patients were divided into two groups according to different operation methods,36 cases in each group. The observation group adopted laparoscopic portal azygous vein disconnection combined with splenectomy;the control group adopted the conventional laparotomy. The clinical effect for two groups was observed. Results The operation was successful. The average operation time for observation group was longer than that of control group. The intraoperative bleeding amount,time of leaving bed,average evacuation time and hospital stays of observation group was better than that of control group. The incidence rate of complications(7. 7% )of observation group was lower than that of control group(46. 2% )(P < 0. 05). Conclusion Laparoscopic portal azygous devascularization operation + spleen re-section for the treatment of liver cirrhosis and portal hypertension recently and the curative effect is better than traditional open surgery and is worthy of clinical application.