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目的比较气囊法组和直接法组建立腹膜后腔的临床价值。方法对2005年5月-2008年12月32例后腹腔镜手术建立腹膜后腔的临床资料进行比较,统计分析两种腹膜后腔建立方法在时间、空间大小、食指经穿刺孔能否触及肾脏、并发症发生率、出血量等的差别。结果两种方法均成功建立腹膜后腔。气囊法组建立腹膜后腔时间平均为(13.17±1.40)min,直接法组为(4.45±1.20)min。气囊法组腹膜后腔空间为(396.00±13.33)mL,直接法组为(85.50±6.05)mL。气囊法组食指经穿刺孔能触及肾脏6例(50%),直接法组无1例(0%)。组间比较,差异有统计学意义(P<0.01)。两组患者建立空间后经观察均为少量渗血,气囊法组发生气囊爆裂1例。结论直接法组在时间上明显优于气囊法组,与气囊法组比较并未增加相关并发症,但建立的空间较小;在熟练掌握了气囊法组后可以运用直接法组建立腹膜后腔。
Objective To compare the clinical value of establishing the retroperitoneal space in balloon group and direct group. Methods The clinical data of 32 cases of retroperitoneal laparoscopic retrosplenectomy were retrospectively analyzed from May 2005 to December 2008. Statistical analysis was made on the methods of establishing the retroperitoneal space in terms of time and space, and whether the index finger could reach the kidney through the puncture hole , The incidence of complications, bleeding and other differences. Results Both methods established retroperitoneal cavity successfully. The mean time to establish retroperitoneal space was (13.17 ± 1.40) min in balloon group and (4.45 ± 1.20) min in direct group. The space of retroperitoneal space was (396.00 ± 13.33) mL in balloon group and (85.50 ± 6.05) mL in direct group. There were 6 cases (50%) of the kidneys that the index finger of the balloon group could reach through the puncture hole, and no one case (0%) of the direct group. The differences between the two groups were statistically significant (P <0.01). Two groups of patients after the establishment of space were observed by a small amount of oozing, balloon bag burst occurred in 1 case. Conclusion The direct method group is obviously superior to the balloon method group in time, but it does not increase the complication compared with the balloon method group, but it has less space to establish. In the direct method group, the retroperitoneum .