腹腔镜微创手术治疗小儿先天性胆管扩张症的疗效观察

发布时间：2018-04-15 08:22

本文选题：小儿 + 微创　；参考：《青岛大学》2017年硕士论文

【摘要】：目的:研究对腹腔镜微创手术治疗先天性胆管扩张症的临床应用对比研究分析。方法:搜集整理济宁医学院附属湖西医院小儿外科(单县中心医院小儿外科)2010年1月至2016年12月先天性胆管扩张症的住院患儿临床病例资料,依据手术方式的不同分为观察组和对照组。其中观察组治疗方案采用腹腔镜微创手术,对照组治疗方案采用传统开腹手术。总结分析两组患儿平均手术时间、术中出血量、肠外营养时间、住院时间、治疗效果、术后并发症等情况。应用统计学分析评分进行相关方面比较,对其临床疗效获得客观、真实、准确的评价。结果:腹腔镜微创治疗先天性胆管扩张症,手术中出血量少,手术后出现吻合口瘘、胆漏、肠襻梗阻等并发症的风险明显降低。腹腔镜患儿术后恢复快、住院时间短、而且切口隐蔽,切口瘢痕小。本研究中采用腹腔镜微创治疗先天性胆管扩张症患儿与传统手术治疗比较,观察组患儿的手术时间比对照组手术时间长;观察组术中出血量、肠外营养时间、以及平均住院时间均显著低于对照组,差异有统计学意义(P0.05);对照组患儿术后并发症发生比例(36%)与观察组患儿术后并发症发生比例(11.1%)相比,差异有统计学意义(P0.05)。结论:同开腹手术对比,腹腔镜微创治疗先天性胆管扩张症虽耗时长,但能显著减少出血量,缩短肠外营养与住院时间,恢复快,术后并发症发生率、复发率低,进而有利促进患儿的预后康复进程,临床应用效果十分显著,值得积极应用与推广。
[Abstract]:Objective: to study the clinical application of laparoscopic minimally invasive surgery in the treatment of congenital cholangiectasis.Methods: the clinical data of inpatients with congenital biliary dilatation in Huxi Hospital affiliated to Jining Medical College (Department of Pediatric surgery, Shanxian Central Hospital) from January 2010 to December 2016 were collected and analyzed.According to the different operation methods were divided into observation group and control group.The observation group was treated by laparoscopic minimally invasive surgery, the control group was treated by traditional open surgery.The average operation time, intraoperative blood loss, parenteral nutrition time, hospitalization time, therapeutic effect and postoperative complications were summarized and analyzed in the two groups.The clinical efficacy was evaluated objectively, truthfully and accurately by statistical analysis.Results: the risk of complications such as anastomotic leakage bile leakage and intestinal loop obstruction after operation was significantly reduced.Laparoscopic children recovered quickly, hospital stay was short, incision was concealed and scar was small.In this study, laparoscopic minimally invasive treatment of children with congenital bile duct dilatation compared with the traditional surgical treatment, the observation group children's operation time longer than the control group, the observation group intraoperative blood loss, parenteral nutrition time,The average hospitalization time was significantly lower than that in the control group (P 0.05), and the incidence of postoperative complications in the control group was 36% (P < 0.01), which was significantly higher than that in the observation group (P 0.05).Conclusion: compared with open surgery, laparoscopic minimally invasive treatment of congenital cholangiectasis may take a long time, but it can significantly reduce the amount of bleeding, shorten the time of parenteral nutrition and hospital stay, recover quickly, and the incidence of postoperative complications and recurrence rate is low.It is beneficial to promote the prognosis and rehabilitation process of children, and the clinical application effect is very remarkable, which is worthy of active application and promotion.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R726.5

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