经腹腔镜手术与开放手术治疗原发性膀胱憩室临床效果比较  

Comparision of the therapeutic effects of laparoscopic surgery and open surgery on primary bladder diverticula

作　　者：徐加龙[1] 孙小刚[1] 王军锋[1] 刘倩[1] 马楠[1] 李殿国[1] 陈维秀[1] 李金良[1] 王若义[1] XU Jialong SUN Xiaogang WANG Junfeng LIU Qian MA Nan LI Dianguo CHEN Weixiu LI Jinliang WANG Ruoyi(Department of Pediatric Surgery, Second Hospital of Shandong University, Jinan 250033, Shandong, Chin)

机构地区：[1]山东大学第二医院小儿外科,山东济南250033

出　　处：《山东大学学报（医学版）》2017年第7期95-99,共5页Journal of Shandong University:Health Sciences

摘　　要：目的比较经腹腔镜手术与开放手术治疗原发性膀胱憩室的临床效果。方法回顾性分析2009年9月至2016年7月收治的22例原发性膀胱憩室患者的临床资料,分为开放手术组12例,腹腔镜手术组10例。采用两独立样本均数t检验,比较两组患者手术时间及术中出血量。采用配对t检验,分别比较两组患者术前、术后排尿时膀胱压力及尿流率结果。采用两独立样本均数近似t检验,比较两组患者术前、术后排尿时膀胱压力及尿流率数值变化。结果腹腔镜手术组较开放手术组手术时间延长(P<0.05),出血量减少(P<0.05)。开放手术组术后随访(13.6±4.0)个月,腹腔镜手术组术后随访(13.6±5.7)个月。两组患者术后排尿时膀胱压力均较术前降低(P<0.05);术后最大尿流率均较术前增加(P<0.05)。术后患者尿流曲线改善。比较两组患者术前、术后排尿时膀胱压力及尿流率数值变化,差异均无统计学意义(P>0.05)。术后均未再出现膀胱输尿管返流,无膀胱憩室复发,排尿正常,未再出现排尿困难。结论经腹腔镜切除原发性膀胱憩室,手术创伤小,出血少,与开放手术效果无明显差异,是理想的微创手术方式。Objective To compare the therapeutic effects of laparoscopic surgery and open surgery on primary bladder diverticula. Methods The data of 22 patients with primary bladder diverticula enrolled from September 2009 to July 2016 were retrospectively reviewed. Twelve patients underwent open bladder diverticulectomy（ open surgery group）, ten patients underwent laparoscopic diverticulectomy （ laparoscopy group）. The operation time and operative hemorrhage of the two groups were compared with independent sample t test. The pre-operative and post-operative urodynamics were separately compared with paired-samples t test. The numerical variations of voiding detrusor pressure and maximum pressure flow in the two groups were compared with separate variance estimation t test. Results The operation time in laparoscopy group was longer than that in open surgery group （ P 〈 0.05 ）. The operative hemorrhage in laparoscopy group was less than that in open surgery group （P 〈0.05）. The follow-up time of open surgery group was （ 13.6 ± 4.0） months. The follow-up time of laparoscopy group was （13.6 ± 5.7） months. The post-operative voiding detrusor pressure was lower than that in pre-operation in both groups （ P 〈 0.05 ）. The maximum pressure flow increased after the operation in both groups （ P 〈 0.05 ）. Urine flow curve was improved after the operation. The numerical variations of voiding detrusor pressure and maximum pressure flow pre-operation and post-operation in both groups showed no sta- tistical difference （ P 〉 0.05 ）. Pre-operative ipsilateral vesicoureteric refluxes disappeared after the surgery. There were no recurrence of bladder diverticula. The patients were asymptomatic in the follow up. Conclusion There is no differ- ence between the therapeutic effect of laparoscopic bladder diverticulectomy and open surgery. Laparoscopic bladder di- verticulectomy is an ideal way of minimally invasive surgery, with small trauma and less bleeding.

关 键 词：原发性 膀胱憩室 腹腔镜 憩室切除 儿童 

分 类 号：R726.9[医药卫生—儿科]