刘清华 陈颖 李万华 汪陵 蹇泽英

[摘要] 目的 探讨手助腹腔镜和开腹脾切除贲门周围血管离断术对肝硬化门脉高压症治疗效果及安全性。方法 随机抽取肝硬化门脉高压症患者60例进行研究，均为2016年7月—2017年7月期间该院消化科收治，按照随机数字法分组，就开腹脾切除术联合贲门周围血管离断术治疗（对照组，n=30）与手助腹腔镜联合贲门周围血管离断术治疗（观察组，n=30）对手术操作用时等相关指标展开对比。结果 观察组患者手术操作用时为（101.41±13.12）min、术中实际出血量为（224.83±20.06）mL、术后引流量为（697.11±46.12）mL、术后肛门排气时间为（2.14±0.26）d、切口长度为（9.84±5.13）cm、禁食时间为（68.23±21.17）h、术后镇痛次数为（0.91±0.03）次、住院时长为（12.12±1.09）d，并发症发生率为6.7%，以上指标明显低于对照组（P<0.05）。结论 手助腹腔镜联合贲门周围血管离断术治疗肝硬化门脉高压症效果较好，住院时间较短，并发症较少，值得临床推广应用。

[关键词] 手助腹腔镜；开腹脾切除术；贲门周围血管离断术；肝硬化；门脉高压

[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2018）03（b）-0020-03

Analysis of Comparison of Effect and Safety of Hand-assisted Laparoscopy and Pericardial Devascularization Versus Open Surgery in Treatment of Portal Hypertension due to Cirrhosis

LIU Qing-hua， CHEN Ying， LI Wan-hua， WANG Ling， JIAN Ze-ying

Department of General Surgery， Pingdingshan Branch of Chongqing Public and Health Medical Treatment Center， Chongqing， 400030 China

[Abstract] Objective To study the effect and safety of hand-assisted laparoscopy and pericardial devascularization versus open surgery in treatment of portal hypertension due to cirrhosis. Methods 60 cases of patients with portal hypertension due to cirrhosis admitted and treated in our hospital from July 2016 to July 2017 were selected and randomly divided into two groups with 30 cases in each， respectively treated with hand-assisted laparoscopy and pericardial devascularization versus open surgery， and the operation time was compared between the two groups. Results The operation time， intraoperative bleeding amount， postoperative drainage amount， postoperative anus exhaust time， incision length， fasting time， postoperative analgesia frequency， length of stay， incidence rate of complications in the observation group were respectively （101.41±13.12）min， （224.83±20.06）mL， （697.11±46.12）mL， （2.14±0.26）d， （9.84±5.13）cm， （68.23±21.17）h， （0.91±0.03）times， （12.12±1.09）d， 6.7%， which were obviously lower than those in the control group（P<0.05）. Conclusion The effect of hand-assisted laparoscopy and pericardial devascularization versus open surgery in treatment of portal hypertension due to cirrhosis is better， with short length of stay， and few complications， which is worth clinical promotion and application.

[Key words]Hand-assisted laparoscopy； Open splenectomy； Pericardial devascularization versus； Cirrhosis； Portal hypertension

肝硬化門脉高压症患者若治疗不及时会出现上消化道出血现象，加重患者病情，对其健康以及生活质量均有严重影响，临床治疗该病的方法主要有手助腹腔镜以及开腹脾切除术，手助腹腔镜属于新兴的腹腔镜手术，相对于开腹脾切除术来说安全性更高，可有效降低手术难度，提高临床疗效，达到缓解症状、控制病情以及改善预后的目的[1-2]。该次研究随机选取2016年7月—2017年7月该院消化科收治的肝硬化门脉高压症患者60例进行研究，探讨手助腹腔镜和开腹脾切除贲门周围血管离断术对肝硬化门脉高压症治疗效果及安全性，现报道如下。……