腹腔镜辅助下改良Soave短肌鞘术式治疗儿童常见型HSCR的术后短期并发症和疗效分析  

Short-term complications and efficacy of laparoscopic assisted modified Soave transanal endorectal pull-through for children with common type HSCR

作　　者：陈媛 CHEN Yuan(Dalian Children's Hospital,Dalian 116012,China)

机构地区：[1]辽宁省大连市儿童医院,116012

出　　处：《中国实用医药》2021年第7期16-18,共3页China Practical Medicine

摘　　要：目的探讨腹腔镜辅助下改良Soave短肌鞘术式治疗儿童常见型先天性巨结肠症(HSCR)的术后短期并发症及疗效。方法 60例儿童常见型HSCR患儿,按照随机数字表法分为对照组和观察组,每组30例。两组患儿均实施腹腔镜辅助下Soave短肌鞘术,对照组实施传统术式,观察组实施改良术式。比较两组患儿手术指标、术后并发症发生情况、术后恢复时间指标、术后疼痛评分。结果两组患儿手术时间比较差异无统计学意义(P>0.05);观察组患儿术中出血量(16.27±5.14)ml少于对照组的(23.61±5.87)ml,差异具有统计学意义(P<0.05)。观察组患儿术后并发症发生率3.33%低于对照组的20.00%,差异具有统计学意义(P<0.05)。观察组患儿术后肛管拔除时间、恢复进食时间、住院时间均短于对照组,差异具有统计学意义(P<0.05)。术后12、24、36、48 h,观察组患儿疼痛评分均低于对照组,差异具有统计学意义(P<0.05)。结论腹腔镜辅助下改良Soave短肌鞘术可减少儿童常见型HSCR患儿的手术创伤,减轻术后疼痛感,降低术后并发症发生风险,加快术后恢复速度,近期疗效良好。Objective To discuss the short-term complications and efficacy of laparoscopic assisted modified Soave transanal endorectal pull-through for children with common Hirschsprung’s disease(HSCR). Methods A total of 60 cases of common HSCR were divided into control group and observation group according to random numerical table, with 30 cases in each group. Both groups received laparoscopic assisted modified Soave transanal endorectal pull-through. The control group received traditional procedure, and the observation group received modified procedure. The surgical indicators, occurrence of postoperative complications, postoperative recovery time index, and postoperative pain score were compared between the two groups. Results There was no statistically significant difference in operation time between the two groups(P>0.05). The intraoperative blood loss(16.27±5.14) ml of the observation group was less than(23.61±5.87) ml of the control group, and the difference was statistically significant(P<0.05). The incidence of postoperative complications 3.33% of the observation group was lower than 20.00% of the control group, and the difference was statistically significant(P<0.05). The time of anal canal extubation, time to resume food-taking and hospitalization time of the observation group were all shorter than those of the control group, and the difference was statistically significant(P<0.05). In postoperative 12, 24, 36 and 48 h, the pain score of the observation group was lower than that of the control group, and the difference was statistically significant(P<0.05). Conclusion Laparoscopic assisted modified Soave transanal endorectal pull-through can reduce the surgical trauma, postoperative pain, reduce the risk of postoperative complications, accelerate the recovery rate, and has a good short-term effect.

关 键 词：先天性巨结肠症 腹腔镜 改良Soave短肌鞘术 并发症 

分 类 号：R726.5[医药卫生—儿科]