中国现代医学杂志2016，Vol.26Issue(22)：54-58,5.DOI:10.3969/j.issn.1005-8982.2016.22.012
腹腔镜与开腹脾切除术在治疗肝硬化所致脾功能亢进中的对比研究
Comparison of laparoscopic and open splenectomy for treatment of hypersplenism caused by liver cirrhosis
摘要
Abstract
Objective To compare the clinical effect of laparoscopic splenectomy and open splenectomy in thetreatment of patients with hypersplenism caused by liver cirrhosis so as to provide a reference for surgical treatment for liver cirrhosis -induced hypersplenism. Methods Forty -six patients who received surgical treatment for hypersplenism caused by liver cirrhosis from January 2012 to December 2015 were chosen as the research subjects, and were divided into observation group and control group ( = 23 in each group) using the random number table method. The control group underwent open splenectomy, while the observation group underwent laparoscopic splenectomy. Surgery related indicators, liver function, inflammatory reaction and immune function were compared between the two groups. Results The operation time of the observation group was longer than that of the control group ( < 0.05). The extubation time and postoperative hospitalizatio n time of the observation group were significantly shorter than those of the control group ( < 0.05). The incision pain of the observation group was milder than that of the control group ( <0.05). The detection of liver function revealed serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST), total bilirubin and direct bilirubin (Dbil) levels were significantly lower than those of the control group 1 d after operation ( < 0.05); ALT, AST and Dbil levels in the observation group were significantly lower than those of the control group 7 d after operation ( < 0.05). Detection of inflammatory immune function showed 1 and 3 days after operation, white blood cell count (WBC), C reactive protein (CRP), and CD8+T cell percentage of the observation group were significantly lower than those of the control group ( < 0.05) ; CD4+T cell percentage and CD4 +/CD8 + T cell ratio were signific antly higher than those of the control group ( < 0.05). Conclusions Laparoscopic splenectomy is helpful in relieving pain of patients, reducing influence on liver function and inflammatory response, protecting immune function, and promoting recovery of patients after operation.关键词
肝硬化致脾功能亢进/腹腔镜脾脏切除术/肝功能/炎症因子/免疫功能Key words
liver cirrhosis-induced hypersplenism/laparoscopic splenectomy/inflammatory cytokine/liver function/immune function分类
医药卫生引用本文复制引用
凌新建,昝建宝,余宏铸..腹腔镜与开腹脾切除术在治疗肝硬化所致脾功能亢进中的对比研究[J].中国现代医学杂志,2016,26(22):54-58,5.基金项目
安徽省年度重点科研项目 （）
