隧道法在全腹腔镜脾切除术中的应用

发布时间：2018-01-27 11:18

本文关键词： 腹腔镜脾蒂控制法脾切除手术入路　出处：《重庆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的探讨隧道法用于全腔镜下脾脏切除术的手术技巧及可行性。方法我科从2015年9月至2016年9月,共施行88例肝硬化巨脾切除术,所有患者根据是否采用了隧道法行全腔镜下脾切除术优化的手术流程分为两组,其中40例未实施隧道法全腔镜脾切除的患者为对照组,48例实施隧道法全腔镜脾切除的患者为观察组。2组患者所有数据通过查阅病例回顾性收集。结果与对照组相比,隧道法全腔镜脾切除的患者术中出血量更少(247.50±135.89 vs.361.75±144.43ml,P0.01),手术时间更短(194.69±47.99 vs.232.75±45.26min,P0.01)。2组患者在中转开腹率、术中输血率、术后住院天数术后并发症无显著统计学差异(P0.05)。实验组术后1例患者出现食管瘘,经保守治疗后于31天顺利出院。两组均无死亡病例。结论隧道法用于全腔镜下脾切除术安全、有效,尤其值得在初学者中推广应用。
[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.

【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R657.6

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