腹腔镜技术在小儿急腹症中的临床应用分析  

Analysis of Laparoscopic Technique Clinical Application in the Treatment of Children with Acute Abdomen

作　　者：付月云[1] 王红旭[1] 陈志权[1] 陈志明[1] 

机构地区：[1]英德市人民医院,广东英德513000

出　　处：《中外医学研究》2016年第16期5-7,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨腹腔镜微创技术在小儿急腹症疾病中的应用及优势。方法:选取本院2010年4月-2013年1月收治的小儿急腹症患者135例为腹腔镜组,同期行开腹手术患者61例为开放组,比较两组患者的临床资料,包括手术时间、术后恢复情况、住院时间及预后跟踪随访资料,针对腹腔镜手术的优缺点进行分析和评价。结果:腹腔镜组中,急性阑尾炎111例,肠套叠9例,腹股沟斜疝嵌顿10例,肠扭转3例,消化道穿孔2例。开放组中,急性阑尾炎43例,消化道穿孔3例,腹股沟嵌顿疝6例,肠套叠6例,肠扭转3例。所有腹腔镜组患者均顺利完成手术。腹腔镜组与开放组中的阑尾炎患者手术时间分别为(51.13±25.23)min和(65.24±30.13)min(P=0.041),术中出血量分别为(2.13±0.58)ml和(4.24±0.79)ml(P=0.024);术后排气时间为(2.21±0.43)d和(2.53±0.76)d(P=0.037),术后住院时间为(6.52±1.22)d和(7.89±1.78)d(P=0.021),比较差异均有统计学意义(P<0.05)。并发症分析显示,腹腔镜组术后肠梗阻1例(0.7%),切口感染5例(3.7%),腹腔感染1例(0.7%),而开放组术后以上指标分别为4例(6.6%),8例(13.1%),3例(4.9%)。结论:腹腔镜在小儿急腹症的治疗过程中安全可靠,并可明确诊断,值得广泛推广运用。Objective:To discuss the application and advantages of laparoscopic technique in the treatment of children with acute abdomen.Method:One hundred and thirty-five children with acute abdomen undergoing laparoscopic surgery in our hospital from April 2010 to January 2013 were selected as the objects (laparoscopy group),while 61 children underewent laparotomy in the same period were selected as the open operation group.The clinical data including time of operation,postoperative recovery,hospitalization and follow-up data of the two groups were recorded and compared.The information of indications,procedures, advantages and disadvantages of laparoscopic surgery were analyzed and evaluated.Result:The 135 patients in the laparoscopic surgery group were including 111 cases of acute appendicitis,9 cases of indigitation,10 cases of incarcerated hernia,3 cases of congenital malrotation of intestine,and 2 cases of gastrointestinal perforation.The open operation grounp was including 43 cases of acute appendicitis,6 cases of indigitation,6 cases of incarcerated hernia,3 cases of congenital malrotation of intestine,and 3 cases of gastrointestinal perforation.All patients in the laparoscopic group were successfully completed the surgery.As to all of the acute appendicitis patients in the group of laparoscopy group and the open operation group,the operation time were (51.13±25.23)min and (65.24±30.13) min(P=0.041);The blood loss were (2.13±0.58)ml and (4.24±0.79)ml(P=0.024),the intestinal function recovery time were (2.21±0.43)d and (2.53±0.76)d (P=0.037),hospital stays were (6.52±1.22)d and (7.89±1.78)d(P=0.021),the differences above were statistically significant(P<0.05).The complications of the two groups revealed that there were 1 case(0.7%) of intestinal obstruction,5 cases(3.7%) of infection of incisional wound,1 case(0.7%) of abdominal infection in the laparoscopic group,but 4 cases(6.6%) of intestinal obstruction,8 cases(13.1%) of infection of incisional wound,3 cases(4.9%) of abdominal infection in the open operat

关 键 词：腹腔镜 小儿 急腹症 适应证 

分 类 号：R726.5[医药卫生—儿科]