JOURNAL OF CLINICAL SURGERY ›› 2022, Vol. 30 ›› Issue (7): 691-693.doi: 10.3969/j.issn.1005-6483.2022.07.027

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Analysis of clinical efficacy hemodynamic indexes and prognosis of laparoscopic splenectomy and EVLS therapy in the treatment ofportal hypertension patients

  

  1. Department of Vascular Surgery,No.2 Affiliated Hospital,Xuzhou Medical University,Jiangsu Xuzhou 221000,China
  • Received:2021-09-23 Accepted:2021-09-23 Online:2022-07-20 Published:2022-07-20

Abstract: Objective To investigate the analysis of clinical efficacy、hemodynamic indexes and prognosis of laparoscopic splenectomy and Endoscopicvariceal ligation and sclerotherapy in the treatment of portal hypertension patients. Methods From August 2015 to January 2018, 91 patients with PHT were admitted,according to the treatment were divided into control group(n=45) and group(n=46),the control group using cardiac blood vessels around from surgery combined therapy with laparoscopic splenectomy,the team used laparoscopic splenectomy in combination with endoscopic sequential ligation and hardener treatment,compared two groups of clinical curative effect. Results The intraoperative bleeding(241.1±82.0)ml,postoperative abdominal drainage(473.8±122.3)ml,postoperative anal venting time(2.1±0.5)d,awake rate(15.2%) and postoperative hospital stay(11.3±2.2)d in the study group were better than those in the control group[(363.4±118.2)ml,(677.5±154.0)ml,(3.5±0.9)d,35.6% and (16.0±3.4)d](P<0.05).The postoperative serum inflammatory indexes[TNF-α:(38.1±9.3)ng/L,IL-6:(27.6±7.2)ng/L and CRP:(41.6± 11.2)mg/L] and hemodynamic parameters[PVP:(21.5±1.5)mmHg,PVV:(18.7±2.7)cm/s,PVD:(11.4±0.5)mm and PVF:(535.7±90.6)ml/min] compared with the control group[TNF-α:(73.0±11.1)ng/L,IL-6:(40.3±4.4)ng/L and CRP:(68.4±12.0)mg/L;PVP:(25.4±1.8)mmHg,PVV:(19.4±3.0)cm/s,PVD:(13.2±0.6)mm and PVF:(739.4±93.8)ml/min](P<0.05).After six months,there was not statistically significant in sithe Child-Pugh score compared with the two groups(P>0.05). Conclusion The laparoscopic splenectomy and EVLS therapy in the treatment of portal hypertension patients has a better therapeutic effect, which can not only reduce the inflammatory response of patients, but also have little influence on hemodynamics and prognosis.

Key words: laparoscopic splenectomy, endoscopicvariceal ligation and sclerotherapy, portal hypertension, clinical efficacy, hemodynamic indexes, prognosis

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