【摘要】：目的:對(duì)比分析腹腔鏡脾切除術(shù)與開(kāi)腹脾切除術(shù)治療特發(fā)性血小板減少性紫癜的圍手術(shù)期結(jié)果及長(zhǎng)期療效。方法:回顧性分析2011年1月至2015年1月我院肝膽外科124例特發(fā)性血小板減少性紫癜患者行脾切除術(shù)治療(其中腹腔鏡脾切除術(shù)68例,開(kāi)腹脾切除術(shù)56例)的臨床資料與隨訪(fǎng)結(jié)果。結(jié)果:腹腔鏡脾切除術(shù)組手術(shù)時(shí)間較開(kāi)腹脾切除術(shù)組長(zhǎng),住院時(shí)間短,術(shù)中失血量少,術(shù)后疼痛輕,術(shù)后拔出引流管時(shí)間短,術(shù)后并發(fā)癥發(fā)生率低。腹腔鏡脾切除術(shù)組術(shù)后無(wú)下肢深靜脈血栓(DVT)發(fā)生;開(kāi)腹脾切除術(shù)組術(shù)后1例發(fā)生DVT。腹腔鏡脾切除術(shù)組術(shù)后1例死于肺部感染。腹腔鏡脾切除術(shù)組平均隨訪(fǎng)時(shí)間(33±11.8)個(gè)月,開(kāi)腹脾切除術(shù)組平均隨訪(fǎng)時(shí)間(32±12.9)個(gè)月,腹腔鏡脾切除術(shù)組中術(shù)后長(zhǎng)期有效率為73.5%,開(kāi)腹脾切除術(shù)組中術(shù)后長(zhǎng)期有效率為76.7%(P0.05)。Kaplan-Meier分析顯示,2組無(wú)復(fù)發(fā)生存率差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.697)。結(jié)論:腹腔鏡脾切除術(shù)治療特發(fā)性血小板減少性紫癜的圍手術(shù)期及長(zhǎng)期療效與開(kāi)腹脾切除術(shù)相當(dāng),但具有非常明顯的微創(chuàng)優(yōu)勢(shì)。
[Abstract]:Objective: to compare the perioperative results and long-term efficacy of laparoscopic splenectomy and open splenectomy in the treatment of idiopathic thrombocytopenic purpura. Methods: from January 2011 to January 2015, 124 patients with idiopathic thrombocytopenic purpura underwent splenectomy in our hospital from January 2011 to January 2015. Clinical data and follow-up results of open splenectomy (56 cases). Results: the operative time of laparoscopic splenectomy group was shorter than that of open splenectomy group, the duration of hospitalization was shorter, the amount of blood loss was less, the postoperative pain was less, the time of pulling out drainage tube was short, and the incidence of postoperative complications was low. (DVT) of deep vein thrombosis of lower extremity was not found in laparoscopic splenectomy group, and DVT. occurred in 1 case in open splenectomy group. One patient died of pulmonary infection in the laparoscopic splenectomy group. The mean follow-up time was (33 鹵11.8) months in the laparoscopic splenectomy group and (32 鹵12.9) months in the open splenectomy group. The long-term effective rate was 73.5% in the laparoscopic splenectomy group. In the open splenectomy group, the long-term effective rate was 76.7% (P0.05). Kaplan-Meier analysis showed that there was no significant difference in the recurrence free survival rate between the two groups (P0. 697). Conclusion: the perioperative and long-term efficacy of laparoscopic splenectomy in the treatment of idiopathic thrombocytopenic purpura is similar to that of open splenectomy, but it has a very obvious advantage of minimally invasive.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R657.6

【參考文獻(xiàn)】

相關(guān)期刊論文 前5條

1 周雄;閻雄;;腹腔鏡脾切除術(shù)治療免疫性血小板減少性紫癜的臨床療效[J];中華消化外科雜志;2015年09期

2 Ravinder Naik Noonavath;Chandrasekharan Padma Lakshmi;Tarun Kumar Dutta;Vikram Kate;;Helicobacter pylori eradication in patients with chronic immune thrombocytopenic purpura[J];World Journal of Gastroenterology;2014年22期

3 Masataka Kuwana;;Helicobacter pylori-associated immune thrombocytopenia:Clinical features and pathogenic mechanisms[J];World Journal of Gastroenterology;2014年03期

4 張華;閻雄;吳忠均;孔憲炳;沈艾;張洪賓;唐曉瓊;王利;;計(jì)算機(jī)斷層掃描血管成像在二級(jí)脾蒂離斷法行腹腔鏡脾切除術(shù)中的臨床價(jià)值[J];重慶醫(yī)科大學(xué)學(xué)報(bào);2013年04期

5 白艷艷;王兆鉞;白霞;繆競(jìng)誠(chéng);張威;戴蘭;沈文紅;阮長(zhǎng)耿;;抗幽門(mén)螺桿菌尿素酶B單抗對(duì)人血小板聚集與活化的影響及其機(jī)制研究[J];中華血液學(xué)雜志;2006年03期

，

本文編號(hào)：2325872