摘要
目的探讨预防和减少腹腔镜脾切除术出血的措施。方法选取2008年1月—2010年3月我院行腹腔镜脾切除术患者40例,超声刀离断脾周韧带,胰腺上缘结扎脾动脉,离断脾门血管,切除脾脏。结果本组40例患者均采用腹腔镜完成手术。术中发现3例副脾,一并切除。手术时间90-210 min,平均130 min。出血50-800 ml,平均160 ml。术后12-24 h胃肠蠕动恢复,术后24 h拔胃管并进流质饮食,术后住院5-9 d。全组无手术死亡,无术后出血、门静脉血栓形成、脏器意外损伤患者。结论结扎脾动脉,避免脾包膜撕裂,妥善处理脾蒂血管可减少腹腔镜脾切除术出血。
Objective To explore measures that can effectively prevent and reduce intraoperative bleeding during laparoscopic splenectomy.Methods Totally 40 patients who underwent laparoscopic splenectomy from January 2008 to March 2010 were enrolled in this study.The splenic surrounding ligaments were cut by ultrasound knife,splenic artery above the pancreatic tail was ligated,the vessels of splenic hilum was cut,and the then the spleen was resected.Results All surgeries were completed under laparoscope.Three accessory spleens were found during the operation and were resected.The operation duration ranged 90-210 min（mean：130 min）.The intra-operative blood loss ranged 50-800 ml（mean：160 ml）.Gastrointestinal motility was recovered 12-24 hours after surgery.Gastric tube was withdrawn 24 hours after surgery,and then liquid diet was provided.The post-operative hospital stay ranged 5-9 days.No surgery-related death was noted.No post-operative bleeding,portal vein thrombosis,incidental organ injury was noted.Conclusion Bleeding during laparoscopic splenectomy may be reduced by ligating splenic artery,avoiding the rupture of spleenic envelope,and proper handling of vessels of splenic hilum.
出处
《中国全科医学》
CAS
CSCD
北大核心
2011年第2期188-189,共2页
Chinese General Practice
