2种外科方法治疗特发性血小板减少性紫癜长期疗效的对比

发布时间：2018-11-11 19:21

【摘要】：目的:对比分析腹腔镜脾切除术与开腹脾切除术治疗特发性血小板减少性紫癜的围手术期结果及长期疗效。方法:回顾性分析2011年1月至2015年1月我院肝胆外科124例特发性血小板减少性紫癜患者行脾切除术治疗(其中腹腔镜脾切除术68例,开腹脾切除术56例)的临床资料与随访结果。结果:腹腔镜脾切除术组手术时间较开腹脾切除术组长,住院时间短,术中失血量少,术后疼痛轻,术后拔出引流管时间短,术后并发症发生率低。腹腔镜脾切除术组术后无下肢深静脉血栓(DVT)发生;开腹脾切除术组术后1例发生DVT。腹腔镜脾切除术组术后1例死于肺部感染。腹腔镜脾切除术组平均随访时间(33±11.8)个月,开腹脾切除术组平均随访时间(32±12.9)个月,腹腔镜脾切除术组中术后长期有效率为73.5%,开腹脾切除术组中术后长期有效率为76.7%(P0.05)。Kaplan-Meier分析显示,2组无复发生存率差异无统计学意义(P=0.697)。结论:腹腔镜脾切除术治疗特发性血小板减少性紫癜的围手术期及长期疗效与开腹脾切除术相当,但具有非常明显的微创优势。
[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 卤11.8) months in the laparoscopic splenectomy group and (32 卤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.
【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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