本文關鍵詞： 腹腔鏡 脾蒂控制法 脾切除 手術入路　出處：《重慶醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的探討隧道法用于全腔鏡下脾臟切除術的手術技巧及可行性。方法我科從2015年9月至2016年9月,共施行88例肝硬化巨脾切除術,所有患者根據(jù)是否采用了隧道法行全腔鏡下脾切除術優(yōu)化的手術流程分為兩組,其中40例未實施隧道法全腔鏡脾切除的患者為對照組,48例實施隧道法全腔鏡脾切除的患者為觀察組。2組患者所有數(shù)據(jù)通過查閱病例回顧性收集。結果與對照組相比,隧道法全腔鏡脾切除的患者術中出血量更少(247.50±135.89 vs.361.75±144.43ml,P0.01),手術時間更短(194.69±47.99 vs.232.75±45.26min,P0.01)。2組患者在中轉開腹率、術中輸血率、術后住院天數(shù)術后并發(fā)癥無顯著統(tǒng)計學差異(P0.05)。實驗組術后1例患者出現(xiàn)食管瘺,經保守治療后于31天順利出院。兩組均無死亡病例。結論隧道法用于全腔鏡下脾切除術安全、有效,尤其值得在初學者中推廣應用。
[Abstract]:Objective to explore the method for tunnel operation skill and the feasibility of laparoscopic splenectomy. Methods from September 2015 to September 2016, a total of 88 cases of liver cirrhosis splenectomy, all patients according to whether the use of the tunnel method for total laparoscopic splenectomy operation optimization process is divided into two groups, including 40 cases of patients with no tunnel method totally laparoscopic splenectomy for the control group, 48 cases of patients with the implementation of tunnel total endoscopic splenectomy for group.2 patients through access to all data collected retrospectively. The results were compared with the control group, the patients in totally laparoscopic splenectomy tunnel less blood loss (247.50 + 135.89 vs.361.75 + 144.43ml, P0.01), shorter operation time (194.69 + 47.99 vs.232.75 + 45.26min, P0.01).2 patients in the laparotomy rate and the rate of intraoperative blood transfusion, postoperative hospital stay and postoperative complications had no significant statistical difference (P0.05). After operation, 1 patients developed esophageal fistula. After conservative treatment, they were discharged successfully on the 31 day. No death occurred in the two groups. Conclusion the tunnel method for total endoscopic splenectomy is safe and effective, especially for beginners.

【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R657.6

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本文編號：1468346