腹腔镜脾切除联合断流术中保留迷走神经在肝硬化门静脉高压患者中的应用

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Abstract Objective To explore the application effect of laparoscopic splenectomy combined with vagus nerve preservation during devascularization in patients with cirrhotic portal hypertension.Methods A total of 74 patients with cirrhotic portal hypertension treated in Jianli Fifth People′s Hospital,Hubei Province from March 2015 to January 2020 were selected as the research objects,and they were divided into control group(n=37,treated with laparoscopic splenectomy combined with devascularization)and observation group(n=37,given vagus nerve preservation on the basis of control group)according to the random number table method.The related surgical indicators(surgical time,intraoperative blood loss,postoperative free portal vein pressure,postoperative gastric juice drainage volume and hospital stay)were compared between the two groups,the quality of life(quality of life in reflux and dyspepsia questionnaire[QOLRAD]score)was compared between the two groups before surgery and at 3 months after surgery,and the incidence rates of complications(postprandial abdominal distension,diarrhea,gastric retention and portal vein thrombosis)were compared between the two groups within 7 d after surgery.Results The surgical time of the observation group was shorter than that of the control group,the difference was statistically significant(P<0.05).The intraoperative blood loss and postoperative gastric juice drainage volume in the observation group were less than those in the control group,the differences were statistically significant(P<0.05).There were no significant differences in the postoperative free portal vein pressure and hospital stay between the two groups(P>0.05).At 3 months after surgery,there was no significant difference in QOLRAD score in the observation group compared with that before surgery(P>0.05).The QOLRAD score at 3 months after surgery in the control group was lower than that of the same group before surgery,the difference was statistically significant(P<0.05).The QOLRAD score at 3 months after surgery in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).Within 7 d after surgery,the incidence rates of postprandial abdominal distension,diarrhea and gastric retention in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence rate of portal vein thrombosis between the two groups(P>0.05).Conclusion Laparoscopic splenectomy combined with vagus nerve preservation during devascularization has more convenient operation in the treatment of patients with cirrhotic portal hypertension,and it can effectively maintain the gastric function,improve the quality of life,and reduce the occurrence of related complications of patients.

Key words： Laparoscopic splenectomy Devascularization Vagus nerve preservation Cirrhotic portal hypertension Gastric function Quality of life

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	LUO Jian
	HE Wen-fa

Cite this article:

LUO Jian,HE Wen-fa. Application of laparoscopic splenectomy combined with vagus nerve preservation during devascularization in patients with cirrhotic portal hypertension[J]. 中国当代医药, 2021, 28(18): 63-66.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2021/V28/I18/63

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