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目的探讨腹部肿瘤联合脾切除适应证的选择、围手术期最佳处理以及脾切除对机体的影响。方法对1993年1月至2004年7月经手术治疗的212例腹部肿瘤联合脾切除病人的临床资料进行回顾性分析。结果腹部原发肿瘤以胃癌最为多见(117/212,55·2%),其次为肝癌合并肝硬化脾功能亢进(28/212,13·2%)和胰体尾癌(23/212,10·8%)。212例病人共行324例次不同类型的手术,共有33例(15·6%)术后发生59例次并发症,发生率为27·8%,以感染最为多见。结论联合脾切除术后并发症的发生与原发疾病和手术种类密切相关,应严格掌握手术适应证,加强围手术期处理是提高近期疗效的关键。
Objective To investigate the choice of indications of abdominal tumor combined with splenectomy, the best perioperative management and the effect of splenectomy on the body. Methods The clinical data of 212 patients with abdominal tumor combined with splenectomy surgically treated from January 1993 to July 2004 were analyzed retrospectively. Results The primary abdominal cancer was the most common gastric cancer (117 / 212,55.2%), followed by liver cancer with cirrhosis and hypersplenism (28 / 212,13.2%) and pancreatic body and tail cancer (23/212, 10.8%). A total of 212 patients underwent 324 different types of surgery, a total of 33 (15.6%) patients had 59 complications (27.8%), the most common infection. Conclusions The incidence of complications after combined splenectomy is closely related to the type of primary disease and operation. Strict indications of surgical indications should be obtained. Perioperative management is the key to improve the short-term efficacy.