经脐单部位腹腔镜在儿童梅克尔憩室诊断及治疗中的应用  

Application for transumbilical single site laparoscopy in the diagnosis and medical treatment of children's Merkel's diverticulum

作　　者：阿尔新.哈布丁 阿布都赛米.阿布都热衣木 颜景灏 李凯[1] 李水学[1] 和军[1] Aerxin·Habuding;Abudousaimi·Abudoureyimu;YAN Jing-hao;LI Kai;LI Shui-xue;HE Jun(Department of Pediatric Surgery,People's Hospital of Xinjiang Uygur Autonomous Region,Xinjiang,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院小儿外科,新疆乌鲁木齐830001

出　　处：《发育医学电子杂志》2019年第1期47-50,共4页Journal of Developmental Medicine (Electronic Version)

基　　金：国家卫计委公益性行业专项基金(201402007)

摘　　要：目的探讨经脐单部位腹腔镜在儿童梅克尔憩室诊断与治疗中的应用价值。方法 2013年5月至2018年5月,新疆维吾尔自治区人民医院小儿外科收治的梅克尔憩室患儿中,共29例采用经脐单部位腹腔镜进行诊断与治疗。其中19例以消化道出血为主要症状就诊,10例以腹痛为主要症状就诊。回顾性分析患儿基本情况、手术过程及治疗结局。结果 29例患儿均行经脐单部位腹腔镜探查术,明确诊断为梅克尔憩室。其中男性19例,女性10例,发病年龄为14个月～8岁。在腹腔镜下,距回盲部20～90 cm的小肠处可见2～7 cm不等的充血水肿的小肠憩室,18例患儿憩室较小,行肠壁斜形吻合;11例患儿憩室较大,行憩室切除+小肠端端吻合术。29例患儿平均手术时间为(59±16)min(40～80 min),术中失血量为2～8 ml,术后5～8 d出院。病理回报均提示异位的胃黏膜细胞。出院后随访3个月,消化道出血患儿未再发生便血,腹痛患儿未出现腹痛,生长发育均在正常范围内。结论对儿童梅克尔憩室行经脐单部位腹腔镜检查及手术治疗,能精准诊断并根治性治疗,具有无瘢痕、创伤小等优点。Objective To explore the application value for transumbilical single site laparoscopy in the diagnosis and medical treatment of children's Merkel diverticulum.Methods From May 2013 to May 2018,29 cases were admitted to the Department of Pediatric Surgery in the People's Hospital of Xinjiang Uygur Autonomous Region.Among of them 19 cases were treated with gastrointestinal bleeding as the main symptom,and 10 cases were treated with abdominal pain as the main symptom.The basic conditions,surgical procedure and treatment outcome were analyzed retrospectively.Results Twentynine infants were underwent transumbilical singlesite laparoscopic exploration with diagnosing as Meckel's diverticulum definitely.Among of them 19 cases were males and 10 cases were females and the onset age was ranged from 14 months to 8 years old.The small intestine diverticulum was found within 2 to 7 cm and edema in the small intestine 20 to 90 cm from the ileocecal area under laparoscopy.Eighteen infants were treated with oblique wall anastomosis due to small intestinal diverticulum.Eleven infants were performed with diverticulum resection+small intestine end anastomosis due to larger intestinal diverticulum.The 29 cases were performed the operation with(59±16)min(40-80 min),the blood loss of them was 2-8 ml during operation,and they were discharged 5 to 8 days after operation.The pathological findings showed ectopic gastric mucosal cells.All patients were followed up for 3 months after discharge.Children with gastrointestinal bleeding did not have any bloody stool more.The infants with abdominal pain never had the symptom and their growth and development were all within the normal range.Conclusions The transumbilical single site laparoscopy is used to exam and surgical treatment for child's Merkel diverticulum.It can diagnose accurately and treat radically and has no scars and small trauma.

关 键 词：梅克尔憩室 经脐单部位腹腔镜 儿童 

分 类 号：R726.5[医药卫生—儿科]