单孔腹腔镜技术在小儿Meckel憩室分型和治疗中的应用

发布时间：2018-07-01 11:26

本文选题：Meckel憩室 + 儿童　；参考：《重庆医学》2017年09期

【摘要】：目的探讨单孔腹腔镜辅助下小儿Meckel憩室分型并指导治疗的可行性。方法回顾性分析该院2011年8月至2015年8月收治的75例有症状Meckel憩室患儿的临床资料,均于单孔腹腔镜下对Meckel憩室分型。根据不同分型选择手术方式,术后均将切除物送病理检查。结果 75例患儿中单纯型50例,复杂型25例。单纯型、复杂型Meckel憩室患儿的平均手术时间分别为(38.93±8.75)、(55.64±13.27)min,平均术中出血量分别为(46.58±15.81)、(50.12±16.90)mL,平均术后住院时间分别为(7.33±1.41)、(7.52±1.68)d,单纯型患儿手术时间短于复杂型患儿(P0.05),其余指标两组比较差异均无统计学意义(P0.05)。单纯型Meckel憩室仅见异位胃黏膜病理改变,复杂型Meckel憩室为炎性表现的比例较高,主要临床表现为下消化道出血和感染的患儿。两组患儿均获随访,随访期间1例单纯型患儿出现腹痛、便血症状,经二次手术后痊愈。结论单孔腹腔镜辅助下可将Meckel憩室分为单纯型和复杂型,可根据不同型别选择手术方式,该方法安全可靠,值得临床推广。
[Abstract]:Objective to investigate the feasibility of typing and guiding the treatment of Meckel diverticulum in children with single hole laparoscopy. Methods the clinical data of 75 children with symptomatic Meckel diverticulum from August 2011 to August 2015 were analyzed retrospectively. All the patients were divided into Meckel diverticulum under single hole laparoscopy. Results in 75 cases, 50 cases were simple type and 25 complicated type. The average operation time of simple type and complex Meckel diverticulum was (38.93 + 8.75) and (55.64 + 13.27) min respectively. The mean intraoperative bleeding was (46.58 + 15.81) and (50.12 + 16.90) mL respectively. The average time of postoperative hospitalization was (7.33 + 1.41) and (7.52 + 13.27) d, respectively. The operation time of the children was shorter than that of the complicated type children (P0.05), and the other two groups had no significant difference (P0.05). The simple Meckel diverticulum was only seen in the pathological changes of the ectopic gastric mucosa, and the proportion of the complicated Meckel diverticulum was higher in the inflammatory performance. The main clinical manifestation was the children with lower gastrointestinal bleeding and infection. All the children were followed up, all of them were followed up. During the follow-up period, 1 cases of simple type children had abdominal pain, symptomatic symptoms and recovered after two operations. Conclusion Meckel diverticulum can be divided into simple and complex type by single hole laparoscopy, and the surgical method can be selected according to different types. This method is safe and reliable, and it is worthy of clinical popularization.
【作者单位】：南京医科大学附属南京儿童医院普外科;
【分类号】：R726.5

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