腹腔镜与开腹Ladd手术治疗新生儿先天性肠旋转不良的疗效比较  

Comparative study on the curative effects of laparoscopic and laparotomy Ladd surgery in the treatment of congenital intestinal malrotation in newborns

作　　者：曹振杰[1] 胡梦蝶 谭诗坤 陈琦[1] 郑明军 傅哲 CAO Zhenjie;HU Mengdie;TAN Shikun;CHEN Qi;ZHENG Mingjun;FU Zhe(Department of Pediatric Surgery,the Third Affiliated Hospital,Zhengzhou University,Zhengzhou 450052)

机构地区：[1]郑州大学第三附属医院小儿外科,郑州450052

出　　处：《郑州大学学报（医学版）》2021年第6期879-883,共5页Journal of Zhengzhou University(Medical Sciences)

摘　　要：目的:探讨腹腔镜与开腹Ladd手术治疗新生儿先天性肠旋转不良的疗效。方法:回顾性分析2017年1月至2020年1月郑州大学第三附属医院收治的64例先天性肠旋转不良患儿的一般资料,根据手术方式的不同将所选患儿分为腹腔镜组(n=32)和开腹组(n=32),均为Ladd手术。两组术后均随访3个月。比较两组术后手术相关指标情况,术前、术后24 h应激指标水平及随访期间的并发症发生情况。结果:腹腔镜组患儿术后开奶、肛门排气及住院时间分别为(2.12±0.62)d、(27.72±4.73)h、(6.12±1.55)d,均短于开腹组[(4.23±1.25)d、(40.65±6.55)h、(10.33±2.31)d](P<0.05)。与术前比较,术后24 h两组血清IL-6、CRP、Cor水平均升高,但腹腔镜组均低于开腹组(P<0.05)。腹腔镜组并发症发生率为25.0%,开腹组并发症发生率为43.8%,差异无统计学意义(P=0.114)。结论:与开腹Ladd手术相比,腹腔镜Ladd手术治疗新生儿先天性肠旋转不良疗效更好。Aim:To explore the curative effect of laparoscopic and laparotomy Ladd surgery in the treatment of congenital intestinal malrotation in newborns.Methods:A retrospective analysis of the general data of 64 children with congenital intestinal malrotation admitted to the Third Affiliated Hospital of Zhengzhou University between January 2017 and January 2020,and the selected children were allocated into the laparoscopic group(n=32)and the laparotomy group(n=32)according to different surgical methods.The laparoscopic group received laparoscopic Ladd surgery,and the laparotomy group received laparotomy Ladd surgery.Both groups were followed up for 3 months.The postoperative operation-related indicators,the levels of stress indicators before and after 24 hours,and the occurrence of complications during the follow-up in the two groups were compared.Results:The postoperative milking time,postoperative anus exhaust time and postoperative hospital stay in the laparoscopic group were(2.12±0.62)days,(27.72±4.73)hours,(6.12±1.55)days,which were shorter than those in the laparotomy group(4.23±1.25)days,(40.65±6.55)hours,(10.33±2.31)days(P<0.05).Compared with preoperatively,the levels of serum IL-6,CRP and Cor in the two groups at 24 hours after surgery increased,but those in the laparoscopic group were lower than those in the laparotomy group(P<0.05).During the follow-up period,the complication rate of the laparoscopic group was 25.0%,that of the laparotomy group was 43.8%,and there was no significant difference between the two groups(P=0.114).Conclusion:Compared with laparotomy Ladd surgery,laparoscopic Ladd surgery for the treatment of congenital intestinal malrotation in newborns has better efficacy.

关 键 词：先天性肠旋转不良 新生儿 腹腔镜Ladd手术 

分 类 号：R726.1[医药卫生—儿科]