腹部肿瘤联合脾切除212例临床分析

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。

Abdominal tumor resection combined with splenectomy: a clinical analysis of 212 cases

Objective To explore the indications, the perioperative managements and the clinical postoperative effects of abdominal tumor resection combined with splenectomy.Methods The clinical data of 212 patients performed abdominal tumor resection combined with splenectomy between January 1993 and July 2004 were analyzed retrospectively.Results Among all cases,the gastric cancer was the most common primary abdominal tumor (117/212,55.2%).The following were primary liver cancer combined with liver cirrhosis and hypersplenism (28/212,13.2 %) and pancreatic cancer (23/212,10.8 %).Three hundreds and twenty-four different types of operations were performed in 212 cases.And 59 complications were developed in 33 patients (27.8 %). Most of which were infection.Conclusions The occurrence of postoperative complications of abdominal tumor resection combined with splenectomy is mostly related with primary tumors and operation types. Thus, it is important to choose the proper patients strictly and a careful perioperative management is the key point to enhance the recent clinical outcome.