腹腔镜微创离断式肾盂成形术与开放性肾盂成形术治疗小儿肾盂输尿管连接部梗阻的临床观察  

Clinical observation of laparoscopic minimally invasive pyeloplasty and open pyeloplasty in the treatment of ureteropelvic junction obstruction in children

作　　者：曾强 曾林山[1] 傅忠[1] Zeng Qiang;Zeng Linshan;Fu Zhong(Department of Pediatric Surgery,The First Affiliated Hospital of Gannan Medical College,Ganzhou,Jiangxi,341000,China)

机构地区：[1]江西省赣南医学院第一附属医院小儿外科,江西赣州341000

出　　处：《当代医学》2020年第28期75-77,共3页Contemporary Medicine

摘　　要：目的探讨腹腔镜微创离断式肾盂成形术与开放性肾盂成形术治疗小儿肾盂输尿管连接部梗阻(UPJO)的临床效果。方法选取2016年2月至2018年9月就诊于本院的84例UPJO患儿,按随机数字表法分为实验组和对照组,各42例。实验组行腹腔镜微创离断式肾盂成形术,对照组行开放性肾盂成形术。比较两组围术期指标、并发症及肾积水复发率。结果两组手术操作时间比较差异无统计学意义;实验组术中出血量、止痛药物使用量分别为(21.15±6.96)mL、(64.23±23.88)mg,少于对照组的(29.21±8.24)mL、(107.39±34.78)mg,差异有统计学意义(P<0.05);实验组术后胃肠功能恢复时间、住院时间分别为(1.68±0.61)d、(7.28±2.48)d,短于对照组的(3.62±1.27)d、(13.49±4.15)d,差异有统计学意义(P<0.05);实验组术后肾积水复发率和并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论与开放性肾盂成形术相比,UPJO患儿行腹腔镜微创离断式肾盂成形术治疗安全性更高,具有创伤小、疼痛轻、恢复快、复发率低等优势。Objective To investigate the clinical effect of laparoscopic minimally invasive pyeloplasty and open pyeloplasty in the treatment of ureteropelvic junction obstruction(UPJO)in children.Methods 84 children with UPJO who were admitted to our hospital from February 2016 to September 2018 were enrolled in the study.They were divided into the experimental group and the control group according to the random number table method,with 42 cases in each group.The experimental group underwent laparoscopic minimally invasive pyeloplasty and the control group underwent open pyeloplasty.Perioperative indicators,complications,and recurrence rate of hydronephrosis were compared between the two groups.Results There was no significant difference in the operation time between the two groups.The amount of intraoperative blood loss and analgesic used in the experimental group were(21.15±6.96)mL,(64.23±23.88)mg,which were less than the control group[(29.21±8.24)mL,(107.39±34.78)mg],and the difference was statistically significant(P<0.05);the recovery time and hospitalization time of the gastrointestinal function in the experimental group were(1.68±0.61)d,(7.28±2.48)d,which were shorter than that in the control group[(3.62±1.27)d,(13.49±4.15)d],and the difference was statistically significant(P<0.05);the recurrence rate of hydronephrosis and the total incidence of complications in the experimental group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion Compared with open pyeloplasty,laparoscopic minimally invasive pyeloplasty is safer in children with UPJO.It has the advantages of less trauma,less pain,quick recovery and low recurrence rate.

关 键 词：肾盂输尿管连接部梗阻 腹腔镜微创离断式肾盂成形术 开放性肾盂成形术 安全性 肾积水 

分 类 号：R726.9[医药卫生—儿科]