改良内镜逆行阑尾炎治疗术在儿童急性非复杂性阑尾炎中的应用研究  

Application of modified endoscopic retrograde appendicitis therapy for acute uncomplicated appendicitis in children

作　　者：张芽龙 林燕 惠娅兴 张安定 曾令超 王春晖 郭宏伟 张鑫慧 江逊 Zhang Yalong;Lin Yan;Hui Yaxing;Zhang Anding;Zeng Lingchao;Wang Chunhui;Guo Hongwei;Zhang Xinhui;Jiang Xun(Department of Pediatrics,Second Affiliated Hospital,Air Force Medical University,Xi'an 71000,China)

机构地区：[1]解放军空军军医大学第二附属医院儿科,西安710000

出　　处：《临床小儿外科杂志》2023年第3期272-277,共6页Journal of Clinical Pediatric Surgery

基　　金：陕西省基金一般项目,社发重点项目(2022SF-082);陕西省卫生健康科研项目(2021E008);空军军医大学第二附属医院临床研究重大项目(2021LCYJ009)

摘　　要：目的探讨改良内镜逆行阑尾炎治疗术(modified endoscopic retrograde appendicitis therapy,mERAT)治疗儿童急性非复杂性阑尾炎的有效性和安全性。方法回顾性分析2018年10月至2021年5月就诊于空军军医大学第二附属医院儿科、诊断为急性非复杂性阑尾炎的228例住院患儿临床资料,并于2022年6月通过电话结合门诊及住院电子化信息系统对其进行随访,随访时间为19(15,22)个月。总结急性非复杂性阑尾炎的临床特点、治疗成功率、治愈出院的患儿1年内复发情况、操作时间(从结肠镜开始进入肛门至治疗完成退出肛门的时间)、总住院时间、mERAT术后住院时间、住院费用、阑尾腔插管成功率、阑尾腔支架置入率、支架自行脱落率、术后取支架时间、住院期间不良事件发生率以及阑尾腔检出粪石、寄生虫及食物种子的病例数。结果纳入研究的228例患儿中,男性127例,女性101例;221例阑尾腔插管成功,阑尾腔插管成功率为96.9%(221/228),治疗成功率为96.9%(221/228);操作时间为40.0(36.0,45.0)min,置入支架率为83.3%(184/221),支架自行脱落率为48.4%(89/184),总住院时间为3(3,4)d,mERAT术后住院时间为2(1,3)d,住院总费用12787.0(11770.1,13585.5)元。失访17例,治愈出院的患儿1年内复发率为6.9%(14/204),住院期间不良事件发生率为3.5%(8/228)。结论mERAT治疗儿童急性非复杂性阑尾炎安全、有效,有较好的应用前景。Objective To evaluate the efficacy and safety of modified endoscopic retrograde appendicitis therapy(mERAT)for acute uncomplicated appendicitis in children.Methods From October 2018 to May 2021,clinical data were retrospectively reviewed for 228 hospitalized children of acute uncomplicated appendicitis.They were followed up by telephone and outpatient and inpatient electronic information systems in June 2022.The follow-up time was 19(15,22)months.Clinical profiles,treatment success rate,recurrence within 1 year of cured and discharged children,operative duration,total hospitalization time,hospitalization time after mERAT,hospitalization expense,success rate of intubation,stent implantation rate,stent self-shedding rate,postoperative stent removal time,number of fecal stones,parasites and food seeds detected in appendix cavity and incidence of adverse events during hospitalization were summarized.Results There were 127 boys and 101 girls.Success rate of intubation was 96.9%(221/228),success rate of treatment 96.9%(221/228)and operative duration 40.0(36.0-45.0)min.Rate of stent placement was 83.3%(184/221)and rate of stent shedding 48.4%(89/184).Total hospitalization time was 3(3,4)day,hospitalization time after mERAT 2(1,3)day and total hospitalization expense 12787.0(11770.1,13585.5)yuan.Seventeen cases were lost to follow-ups and recurrence rate within 1 year was 6.9%(14/204).And the incidence of adverse events during hospitalization was 3.5%(8/228).Conclusion mERAT is both safe and effective for acute uncomplicated appendicitis in children.

关 键 词：自然腔道内镜手术 阑尾炎 外科手术 儿童 

分 类 号：R726.5[医药卫生—儿科]