不同手术方式治疗儿童肾上腺肿瘤的疗效分析  

Curative effect analysis of different surgical methods in the treatment of adrenal tumors in children

作　　者：王允金 陈流[1] 崔旭[1] 林恺楠 许小琴[2] 周朝明[1] Wang Yunjin;Chen Liu;Cui Xu;Lin Kainan;Xu Xiaoqin;Zhou Chaoming(Department of Pediatric Surgery,Fujian Provincial Maternity and Children′s Hospital,Fuzhou 350001,China;School of Public Health,Fujian Medical University,Fuzhou 350001,China)

机构地区：[1]福建省妇幼保健院小儿外科,福州350001 [2]福建医科大学公共卫生学院,福州350001

出　　处：《中华实用儿科临床杂志》2021年第2期118-121,共4页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的探讨腹腔镜和开腹手术治疗儿童肾上腺肿瘤的临床疗效。方法回顾性分析2008年6月至2016年6月福建省妇幼保健院小儿外科治疗的儿童肾上腺肿瘤31例临床资料,依据手术方式不同分为开腹组和腹腔镜组。对2组患儿术中出血量、手术时间、切口长短、术后腹腔引流时间、术后住院时间、术后并发症及复发情况等进行对比分析。结果2组发病年龄、性别、体质量及肿瘤大小比较差异均无统计学意义(均P>0.05)。开腹组术中出血量(18.06±4.86)mL,腹腔镜组术中出血量(15.20±4.48)mL,2组比较差异无统计学意义(T=-1.702,P>0.05);开腹组手术时间(137.44±19.32)min,腹腔镜组手术时间(134.80±6.21)min,2组比较差异无统计学意义(T=-0.504,P>0.05);开腹组手术切口长度(7.94±1.34)cm,腹腔镜组手术切口长度(3.44±0.21)cm,腹腔镜组手术切口长度较短,2组比较差异有统计学意义(T=-12.843,P<0.001);开腹组术后住院天数(9.63±2.55)d,腹腔镜组术后住院天数(7.20±1.37)d,腹腔镜组术后住院天数较短,2组比较差异有统计学意义(T=-3.261,P=0.003);开腹组术后腹腔引流管留置时间(5.94±1.53)d,腹腔镜组引流管留置时间(4.80±1.74)d,2组比较差异无统计学意义(T=-1.938,P>0.05)。腹腔镜组术后发生腹膜后血肿1例,开腹组术后发生并发症2例,2组术后并发症发生率比较差异无统计学意义(P=1.000)。腹腔镜组术后远处转移3例,复发1例;开腹组术后远处转移2例,复发1例,2组术后复发情况比较差异无统计学意义(P=1.000)。结论相对于传统开腹手术,腹腔镜辅助儿童肾上腺肿瘤切除术切口美观、创伤小、术后恢复快,但需要选择合适的病例。Objective To investigate the clinical efficacy of laparoscopic adrenalectomy and traditional open adrenalectomy for adrenal tumors in children.Methods In Department of Pediatric Surgery,Fujian Provincial Maternity and Children′s Hospital from June 2008 to June 2016,the clinical data of 31 pediatric adrenal tumors was retrospectively analyzed.According to different surgical methods,they were divided into traditional open adrenalectomy group and laparoscopic adrenalectomy group.Bleeding loss,operation duration,incision length,abdominal drainage time,postoperative hospital stay,postoperative complications and recurrence were compared between the 2 groups.Results There was no significant difference in age,sex,weight,and tumor size between the 2 groups(all P>0.05).The intraoperative bleeding loss was(18.06±4.86)mL for open adrenalectomy group and(15.20±4.48)mL for laparoscopic adrenalectomy group,and there existed no significant difference in the amount of bleeding between the 2 groups(T=-1.702,P>0.05).The operation duration was(137.44±19.32)min for open adrenalectomy group versus(134.80±6.21)min for laparoscopic adrenalectomy group,and there was no significant difference in operation duration between the 2 groups(T=-0.504,P>0.05).The length of incision was(7.94±1.34)cm for open adrenalectomy group versus(3.44±0.21)cm for laparoscopic adrenalectomy group,the length of incision in laparoscopic group was shorter than that in open adrenalectomy group.There was significant difference in the length of incision between the 2 groups(T=-12.843,P<0.001).The hospitalization time was(9.63±2.55)d for open adrenalectomy group versus(7.20±1.37)d for laparoscopic adrenalectomy group,the hospitalization time in laparoscopic group was shorter than those in open adrenalectomy group.The difference of operation time between the 2 groups was statistically significant(T=-3.261,P=0.003).The average indwelling time of abdominal drainage tube was(5.94±1.53)d for open adrenalectomy group versus(4.80±1.74)d for laparoscopic adrenale

关 键 词：腹腔镜 开放 肾上腺肿瘤 儿童 

分 类 号：R736.6[医药卫生—肿瘤]