单纯经肛门Soave术及腹腔镜辅助治疗先天性巨结肠的临床研究  

Clinical study of simple Soave and laparoscopic assisted abdominal surgery in the treatment of Hirschsprung's disease

作　　者：何朝升[1] 

机构地区：[1]厦门大学附属第一医院儿外科,福建厦门361003

出　　处：《中国现代医生》2017年第25期8-10,14,共4页China Modern Doctor

摘　　要：目的探讨单纯经肛门Soave术及腹腔镜辅助治疗先天性巨结肠患儿的临床价值。方法选择我院86例先天性巨结肠患儿随机分为观察组(行腹腔镜辅助Soave术)与对照组(单纯经肛门Soave术)各43例。对比两组手术相关指标,检测肛门静息压,采用Wingspread评分评估患儿肛门功能,并记录术后并发症发生率。结果观察组总手术时间长于对照组,术中出血量低于对照组(P<0.05)。观察组切除病变肠管长度、肛门操作时间、术后住院时间均短于对照组(P<0.05)。观察组术后3、6个月肛门静息压高于对照组(P<0.05)。两组术后3、6、12个月肛门功能评分优良率比较,差异均无统计学意义(P>0.05)。观察组并发症发生率低于对照组(P<0.05)。结论相比于单纯经肛门Soave术,腹腔镜辅助Soave术术中出血少,肛门操作时间、术后住院时间均较短,对肛门功能损伤小,可降低术后并发症发生率。Objective To investigate the clinical value of simple Soave and laparoscopic assisted abdominal surgery in the treatment of Hirschsprung's disease. Methods A total of 86 cases of Hirschsprung's disease in our hospital were selected and randomly divided into observation group and control group,with 43 cases in each group. The observation group underwent laparoscopic assisted Soave and the control group was treated with Soave alone. The two groups were compared with the surgical indices. Anal resting pressure was measured and Wingspread score was used to evaluate the anal function. The incidence of postoperative complications was recorded. Results The total operation time of the observation group was longer than that of the control group, and the intraoperative blood loss was lower than that of the control group(P<0.05). In the observation group, the length of bowel resection, operation time and postoperative hospital stay were shorter than those of the control group(P<0.05). The resting pressure of the observation group was higher than that of the control group at 3 and 6 months after surgery(P<0.05). The difference was no statistically significant between the two groups in the anal function score at 3, 6 and 12 months after operation(P>0.05). The incidence of complications in observation group was lower than that in control group(P<0.05). Conclusion Compared with Soave alone, laparoscopic assisted abdominal Soave surgery can reduce intraoperative bleeding, shorten operation time and postoperative hospitalization time. It can reduce the injury of anal function and the incidence of postoperative complications.

关 键 词：SOAVE术 腹腔镜 先天性巨结肠 并发症 

分 类 号：R726.1[医药卫生—儿科]