腹腔镜与开腹手术治疗新生儿先天性肠旋转不良的比较研究

发布时间：2018-06-27 00:00

  本文选题：肠旋转不良 + 腹腔镜　； 参考：《中国微创外科杂志》2017年11期

【摘要】：目的比较腹腔镜与开腹手术治疗新生儿先天性肠旋转不良的疗效。方法回顾性分析2011年1月~2015年12月我院手术治疗200例新生儿先天性肠旋转不良的临床资料。2012年11月~2015年12月98例行腹腔镜手术(腹腔镜组),2011年1月~2012年10月102例行开腹手术(开腹组)。比较2组手术时间、术后开奶时间、住院时间、术后并发症和治愈率等。结果腹腔镜组3例因肠系膜血管损伤中转开腹止血。腹腔镜组手术时间(58.2±19.2)min,明显长于开腹组(45.0±9.0)min(t=6.049,P=0.000),但术后开奶时间(2.3±0.8)d,明显早于开腹组(4.2±1.2)d(t=-12.571,P=0.000),住院时间(11.2±2.1)d,明显短于开腹组(13.7±2.7)d(t=-7.200,P=0.000)。2组术后切口裂开[0 vs.4.9%(5/102),Fisher精确检验,P=0.060]、切口疝[0 vs.3.9%(4/102),Fisher精确检验,P=0.122]、肠扭转复发[2.0%(2/98)vs.1.0%(1/102),χ~2=0.001,P=0.972]、粘连性肠梗阻[7.1%(7/98)vs.7.8%(8/102),χ~2=0.035,P=0.851]、阑尾残端漏[1.0%(1/98)vs.1.0%(1/102),χ~2=0.001,P=0.977]、再手术[7.1%(7/98)vs.5.9%(6/102),χ~2=0.131,P=0.718]和治愈率[100.0%(98/98)vs.99.0%(101/102),Fisher精确检验,P=1.000]均无统计学差异。结论腹腔镜手术治疗新生儿先天性肠旋转不良切口小、美观,术后恢复快,但术中要警惕损伤肠系膜血管和肠管。
[Abstract]:Objective to compare the efficacy of laparoscopy and laparotomy in the treatment of congenital intestinal malrotation in neonates. Methods the clinical data of 200 neonates with congenital intestinal malrotation from January 2011 to December 2015 were retrospectively analyzed. From November 2012 to December 2015, 98 cases underwent laparoscopic surgery (laparoscopic group) and 102 cases from January 2011 to October 2012. Open operation (open group). The time of operation, the time of milk opening, the time of hospitalization, the postoperative complications and the cure rate were compared between the two groups. Results in the laparoscopic group, 3 cases were converted to open operation for hemostasis due to mesenteric vascular injury. 鑵硅厰闀滅粍鎵嬫湳鏃堕棿(58.2卤19.2)min,鏄庢樉闀夸簬寮，

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