保留扩张而不肥厚结肠的腹腔镜辅助下手术治疗先天性巨结肠的临床疗效观察  

Observation on the clinical effect of laparoscopic-assisted surgery on Hirschsprung's disease while preserving the enlarged colon

作　　者：杨春[1] 张春霞[1] 姜涛[1] YANG Chun;ZHANG Chun-xia;JIANG Tao(Department of Anorectal Surgery,Shenyang Anorectal Hospital,Shenyang Liaoning 110002,China)

机构地区：[1]沈阳市肛肠医院肛肠外科,辽宁沈阳110002

出　　处：《临床和实验医学杂志》2021年第24期2624-2627,共4页Journal of Clinical and Experimental Medicine

基　　金：辽宁省科学技术厅自然科学基金指导计划项目(编号:20170540840)。

摘　　要：目的探究保留扩张而不肥厚结肠的腹腔镜辅助手术治疗先天性巨结肠的临床疗效。方法选取2018年3月至2020年6月期间沈阳市肛肠医院收治的58例先天性巨结肠患儿为观察对象并对其资料予以回顾分析,依据治疗术式的不同将其分为研究组(n=29)与对照组(n=29)。对照组给予传统经肛门Soave手术,研究组给予保留扩张而不肥厚结肠的腹腔镜辅助手术治疗。观察对比两组术中指标(出血量、手术时间、麻醉时间以及住院时间)、术后肛门功能恢复(排便频次与Krickenbeck评分评估)情况以及并发症发生情况。结果研究组出血量为(5.42±2.87)m L少于对照组[(28.32±12.27)m L],且住院时间为(7.54±2.30)d,显著短于对照组[(11.92±3.21)d],差异均有统计学意义(P<0.05);但研究组手术时间、麻醉时间与对照组比较差异无统计学意义(P>0.05)。术后6个月时,两组肛门功能恢复情况(排便频次与Krickenbeck评分)比较差异无统计学意义(P>0.05);术后12个月,研究组患者的排便频次为(1.22±0.17)次/d,低于对照组[(2.34±0.57)次/d],而Krickenbeck评分为(8.42±0.37)分,高于对照组[(7.23±0.57)分],差异有统计学意义(P<0.05)。研究组并发症总发生率(17.24%)明显低于对照组(44.83%),差异有统计学意义(P<0.05)。结论与传统经肛门Soave手术相比,保留扩张而不肥厚结肠的腹腔镜辅助手术治疗先天性巨结肠能明显提高临床疗效,术后恢复快且并发症少,能够显著改善患者肛门功能,为先天性巨结肠术式的选择提供有价值参考。Objective To investigate the clinical effect of laparoscopic assisted surgery for the treatment of Hirschsprung's disease by preserving dilated but not hypertrophic colon.Methods A total of 58 children with Hirschsprung's disease admitted to Shenyang Anorectal Hospital from March 2018 to June 2020 were selected as observation objects and their data were retrospectively analyzed,based on the surgical treatment of different divided into study group(n=29)and control group(n=29),control group given anal Soave traditional surgery,the team to keep expanding without hypertrophy of laparoscopic assisted colon surgery.Inoperative indicators(blood loss,operative time,anesthesia time and hospital stay)were observed and compared between the two groups.Postoperative recovery of anal function(Krickenbeck score assessment)and the incidence of complications were compared between the two groups.Results The amount of blood loss in the study group was(5.42±2.87)mL,which was less than that in the control group[(28.32±12.27)mL],and the length of hospital stay was(7.54±2.30)days,which was significantly shorter than that in the control group[(11.92±3.21)d],the differences were statistically significant(P<0.05).However,there were no significant differences in operation time and anesthesia time between the study group and the control group(P>0.05).At 6 months after operation,there was no significant difference in the recovery of anal function(defecation frequency and Krickenbeck score)between the two groups(P>0.05).After 12 months,the frequency of defecation in the study group was(1.22±0.17)times/d,which was lower than that in the control group[(2.34±0.57)times/d],while the Krickenbeck score were(8.42±0.37)points,which were higher than those in the control group[(7.23±0.57)points],the differences were statistically significant(P<0.05).The total incidence of complications in the study group(17.24%)was lower than that in the control group(44.83%),and the difference was statistically significant(P<0.05).Conclusion Compared with trad

关 键 词：先天性巨结肠 腹腔镜手术 保留扩张而不肥厚结肠 肛门功能 并发症 

分 类 号：R656.9[医药卫生—外科学]