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目的:探讨腹腔镜下脾血管结扎术治疗小儿遗传性球形红细胞增多症的可行性和有效性。方法:2015年5月至2018年4月，17例儿童因遗传性球形红细胞增多症伴脾大内科治疗效果差，就诊于我院外科。其中，男9例，女8例，年龄0.3～15.3岁，平均8.3岁。所有患儿均接受腹腔镜下脾血管结扎术。术后定期随访，用AW Volume Share 5软件对腹部增强CT的脾脏影像进行体积测量，评估手术前后脾脏体积。迄今随访3～38个月，平均19.8个月。结果:所有手术均成功完成。手术时间60～180 min(平均115 min)，术中出血量为5～50 ml(平均15 ml)，无术中输血患儿。术后住院时间5～9 d(平均7 d)。术后血小板、红细胞及血红蛋白较术前均明显升高(n P<0.05)。术后功能性脾脏体积较术前脾体积明显缩小[(307.393±177.634)cmn 3比(581.242±270.260)cmn 3，n P＝0.000]；其中10例随访1年以上者测量了术后功能性脾脏体积，最近复查时的功能性脾脏体积较术后1个月的功能性脾脏体积显著增大(n P＝0.004)。脾梗死指数(即术后1个月脾梗死体积占术前脾脏体积的百分比)为0.31～0.99(平均为0.53)。术后无一例需继续输血治疗。n 结论:腹腔镜脾血管结扎术是治疗小儿遗传性球形红细胞增多症的有效方式，但远期疗效仍需进一步研究。“,”Objective:To explore the effectiveness and feasibility of laparoscopic ligation of splenic vessels for hereditary spherocytosis in children.Methods:From May 2015 to April 2018, seventeen children with hereditary spherocytosis underwent laparoscopic ligation of splenic vessels.The mean follow-up period was 19.8(3-38) months.The volume of spleen was measured by AW VolumeShare5 preoperatively and postoperatively.Results:Laparoscopic ligation of splenic vessels was successfully performed in all patients.The average operative duration was 115(60-180) min.No intraoperative blood transfusion was offered and the mean length of hospitalization was 7(5-9) days.Red blood cell, platelet and hemoglobin significantly increased postoperatively (n P1 year ( n P=0.004). The mean index of splenic infarction was 0.53(0.31-0.99). No postoperative blood transfusion was offered.n Conclusions:Laparoscopic ligation of splenic vessels is effective for hereditary spherocytosis in children.However, the long-term prognosis shall be re-evaluated in future study.