腹腔镜与传统开腹手术治疗小儿肠套叠的临床疗效比较

发布时间：2018-03-09 15:52

本文选题：肠套叠　切入点：腹腔镜　出处：《中国微创外科杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的探讨腹腔镜手术治疗小儿肠套叠的临床价值。方法回顾性分析2014年5月~2015年5月15例腹腔镜手术(腹腔镜组)治疗小儿肠套叠的临床资料,并与同期22例传统开腹手术(开腹组)进行比较,比较2组手术时间、恢复正常饮食时间、住院时间及并发症等。结果腹腔镜组13例腔镜下复位,成功率86.7%(13/15),中转开腹2例。腹腔镜组手术时间稍短,但2组差异无统计学意义[中位数55 min(39~146 min)vs.67 min(49~158 min),Z=-1.657,P=0.098]。与开腹组比较,腹腔镜组术后恢复正常饮食时间明显缩短[(4.2±1.3)d vs.(5.5±2.1)d,t=-2.007,P=0.053],2组住院时间无统计学差异[(5.2±1.4)d vs.(6.5±2.2)d,t=-1.756,P=0.089]。2组术中、术后并发症各4例,无统计学差异(Fisher精确检验,P=0.433)。腹腔镜组15例随访6~17个月,(11.0±3.5)月:1例术后2个月再次发生肠套叠,经空气灌肠复位成功;余均无异常,无粘连性肠梗阻发生。传统组22例随访6~17个月,(10.7±3.0)月:1例术后1个月发生小肠梗阻,经保守治疗后好转;1例术后3个月再次发生肠套叠,经空气灌肠复位成功;余无异常。结论腹腔镜手术治疗小儿肠套叠安全、有效,不增加术中、术后并发症,对于熟悉腹腔镜操作的医生可作为首选治疗方案。
[Abstract]:Objective to evaluate the clinical value of laparoscopic surgery in the treatment of intussusception in children. Methods from May 2014 to May 15th 2015, the clinical data of children with intussusception treated by laparoscopic surgery (Laparoscopic group) were retrospectively analyzed. And compared with 22 cases of traditional open operation (laparotomy group) in the same period, the operation time, the time of returning to normal diet, the time of hospitalization and complications were compared between the two groups. The success rate was 86.7%, and 2 cases were transferred to laparotomy. The operation time was shorter in the laparoscopy group, but there was no significant difference between the two groups [median 55 min(39~146 min)vs.67 min(49~158 Zhe -1.657% P0. 098], and compared with the open group, there was no significant difference between the two groups. There was no significant difference in the hospitalization time between the two groups [4.2 卤1.3 vs.(5.5 卤2.1 d vs.(5.5 卤2.007P0. 053] there was no significant difference in the hospitalization time between the two groups [5.2 卤1.4d vs.(6.5 卤2.756 vs.(6.5 + 1.756U P0.089] .2 group, the postoperative complications were 4 cases each, and there was no significant difference in the duration of hospitalization between the two groups (P 0. 089, P 0. 089, P 0. 089, P 0. 089, P < 0. 05). In the laparoscopic group, 15 cases were followed up for 6 ~ 17 months and 11. 0 卤3. 5 months after operation. Intussusception occurred again 2 months after operation in 1 case. The reduction of intussusception was successful by air enema. In the traditional group, 22 cases were followed up for 6 ~ 17 months (10.7 卤3.0) months and 1 case had small intestinal obstruction 1 month after operation. After conservative treatment, 1 case had intussusception again 3 months after operation, and the reduction of intussusception by air enema was successful. Conclusion Laparoscopic surgery is safe and effective in the treatment of intussusception in children.
【作者单位】：上海市儿童医院上海交通大学附属儿童医院普外科;
【分类号】：R726.5

【相似文献】