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| Clinical effect comparison between laparoscopic and open splenectomy in the treatment of patients with cirrhotic portal hypertension |
| ZENG Wei |
| Department of General Surgery, Fuzhou First People′s Hospital of Jiangxi Province, Fuzhou 344000, China |
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Abstract Objective To investigate and compare the clinical effect between laparoscopic and open splenectomy in the treatment of patients with cirrhotic portal hypertension. Methods A total of 72 patients with cirrhotic portal hypertension who were diagnosed and treated in our hospital from January 2016 to March 2018 were selected as subjects, and divided into the observation group and the control group by the random number table method, with 36 cases in each group. The control group was treated with open splenectomy, while the observation group was treated with laparoscopic splenectomy. The hospitalization indexes, liver function indexes, white blood cells, platelet and curative effect were compared between the two groups. Results The operation time of the observation group was longer than that of the control group, the intraoperative blood loss was less than that of the control group, the visual analogue scale (VAS) score of incision pain was lower than that of the control group, the postoperative time to get up of bed and postoperative hospital stay were shorter than those in the control group, the differences were statistically significant (P＜0.05). On the 1st and 7th day after the operation, the serum alanine aminotransferase (ALT), serum aspartic aminotransferase (AST), serum total bilirubin (TBil) and serum direct bilirubin (DBil) in the observation group were all lower than those in the control group, with statistically significant differences (P＜0.05). The leucocyte and platelet levels in the observation group were higher than those in the control group one month after the operation, with statistically significant differences (P＜0.05).The total effective rate of the observation group was 94.44%, which was higher than that of the control group (77.78%),and the difference was statistically significant (P＜0.05). Conclusion Laparoscopic splenectomy can relieve the pain caused by surgery, reduce the impact on liver function, and protect the immune function of patients.
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| [1] |
曾道炳，张纯，邸亮，等.脾切除联合门奇静脉断流术对肝硬化合并门静脉高压症患者近远期营养状况的影响[J].中华肝胆外科杂志，2017，23（7）：437-440.
|
| [2] |
张焱辉，蒋国庆，唐俊，等.腹腔镜下巨脾切除加贲门周围血管离断术治疗肝硬化门静脉高压的疗效分析[J].中华普外科手术学杂志（电子版），2017，11（5）：414-416.
|
| [3] |
厉学民，俞世安，龚道军，等.腹腔镜脾肾分流术治疗肝硬化门静脉高压症[J].中华普通外科杂志，2017，32（12）：1071-1072.
|
| [4] |
Zheng X，Liu QG，Yao YM.Total Laparoscopic versus open splenectomy and esophagogastric devascularization in the management of portal hypertension：a comparative study[J].Dig Surg，2009，26（6）：499-505.
|
| [5] |
沈柏用，陈曼，詹维伟，等.肝硬化门静脉高压症的无创诊断[J].上海交通大学学报（医学版），2006，26（6）：611-614.
|
| [6] |
Slakey DP，Simms E，Drew B，et al.Complications of liver resection：laparoscopic versus open procedures[J].JSLS，2013，17（1）：46-55.
|
| [7] |
刘江伟，黄建钊，柳严，等.腹腔镜脾切除术和开腹手术治疗脾功能亢进疗效分析[J].现代医药卫生，2019，35（10）：1538-1540.
|
| [8] |
Bai DS，Qian JJ，Chen P，et al.Modified laparoscopic and open splenectomy and azygoportal disconnection for portal hypertension[J].Surg Endosc，2014，28（1）：257-264.
|
| [9] |
魏云海，尹磊，王雁，等.P-选择素对腹腔镜脾切除术后门静脉血栓形成的早期预测价值[J].腹腔镜外科杂志，2018，23（12）：927-930.
|
| [10] |
杨帅帅，李海玲，武德旺，等.完全3D 腹腔镜与开腹手术治疗门脉高压症的对比研究[J].腹腔镜外科杂志，2017，22（2）：119-122.
|
| [11] |
代坤甫，郝晓沛，董亚东，等.脾床入路腹腔镜脾切除联合贲门周围血管离断术的疗效评价[J].中华普通外科杂志，2018，33（7）：544-547.
|
| [12] |
杨镇，万赤丹，邓小荣.腹腔镜门静脉高压症外科治疗发展与新断流术[J].中华普外科手术学杂志（电子版），2017，11（3）：181-184.
|
| [13] |
何维阳，王彦峰，熊艳，等.肝硬化门静脉高压症患者脾功能亢进的治疗[J].中华肝胆外科杂志，2018，24（2）：133-135.
|
| [14] |
Colecchia A，Marasco G，Taddia M，et al.Liver and spleen stiffness and other noninvasive methods to assess portal hypertension in cirrhotic patientss：a review of the literature[J].Eur J Gastroenterol Hepatol，2015，27（9）：992-1001.
|
| [15] |
严亮.开腹与腹腔镜脾切除术分别联合贲门周围血管离断术治疗肝硬化门静脉高压的疗效比较[J].临床医学研究与实践，2017，2（31）：68-69.
|
|
|
|
