腹腔镜复位手术治疗小儿肠套叠的效果  

Effect of laparoscopic reduction surgery on intussusception in children

作　　者：雷周满 闫跃强 侯家 Lei Zhouman;Yan Yueqiang;Hou Jia(Department of General Surgery,Xuchang Central Hospital,Xuchang 461000,China)

机构地区：[1]河南省许昌市中心医院普外科,461000

出　　处：《中国实用医刊》2022年第1期10-13,共4页Chinese Journal of Practical Medicine

基　　金：2018年许昌市科技计划项目(20170213255)。

摘　　要：目的分析腹腔镜复位手术治疗小儿肠套叠的效果。方法抽取2017年7月至2020年7月许昌市中心医院收治的肠套叠患儿80例,按照随机数字表法分为微创组与开腹组,每组40例。开腹组采用传统开腹手术,微创组采用腹腔镜复位手术。比较两组手术情况及术后恢复情况,比较两组手术前后T淋巴细胞亚群(CD4^(+)、CD8^(+))、一氧化氮(NO)、丙二醛(MDA)、炎性因子[肿瘤坏死因子-α(TNF-α)、高迁移率族蛋白B1(HMGB1)]水平,比较两组并发症发生率及复发率。结果两组复位成功率比较差异未见统计学意义(P>0.05)。微创组手术时间短于开腹组,术中出血量少于开腹组(P<0.05)。微创组术后首次肛门排气时间、下床活动时间、恢复饮食时间、住院时间短于开腹组(P<0.05)。术后24 h,两组CD4^(+)、CD8^(+)计数水平均较术前降低,且微创组CD4^(+)计数水平高于开腹组,CD8^(+)计数水平低于开腹组(P<0.05)。术后24 h,两组血清MDA水平均较术前升高、NO水平均较术前降低,且微创组血清MDA水平高于开腹组、NO水平低于开腹组(P<0.05)。术后24 h,两组血清TNF-α、HMGB1水平均较术前升高,但微创组血清TNF-α、HMGB1水平低于开腹组(P<0.05)。微创组并发症发生率(5.00%,2/40)低于开腹组(20.00%,8/40),P<0.05。两组复发率比较差异未见统计学意义(P>0.05)。结论与开腹手术相比,腹腔镜复位手术治疗小儿肠套叠不会影响复位效果,并且手术创伤小,可缩短术后恢复时间,减轻对炎性因子的影响,减少并发症。Objective To analyze the effects of laparoscopic reduction in the treatment of intussusception in children.Methods A total of 80 children with intussusception treated in Xuchang Central Hospital from July 2017 to July 2020 were selected and divided into minimally invasive group and open surgery group by random number table method,with 40 cases in each group.The open surgery group was treated by traditional open surgery,and the minimally invasive group was treated by laparoscopic reduction surgery.The operation status,postoperative recovery status,preoperative and postoperative T lymphocyte subsets,including cluster of differentiation(CD)4^(+)and CD8^(+),nitric oxygen(NO),malondialdehyde(MDA),levels of inflammatory factors,including tumor necrosis factor-α(TNF-α)and high mobility group box protein 1(HMGB1),complication rate,and recurrence rate of the two groups were compared.Results There was no significant difference in the success rate of reduction between the two groups(P>0.05),but the minimally invasive group had shorter operation time and less intraoperative blood loss than open surgery group(P<0.05).The first postoperative anal exhaust time,postoperative activity time,normal diet time,and hospital stay of minimally invasive group were shorter than those of open surgery group(P<0.05).The CD4^(+)and CD8^(+)levels decreased in both groups 24 h after surgery,compared with preoperative levels(P<0.05);but minimally invasive group had higher CD4^(+)level and lower CD8^(+)level than open surgery group 24 h after surgery(P<0.05).The MDA increased,and NO decreased in both groups 24 h after surgery(P<0.05);but MDA was higher,and NO was lower in minimally invasive group 24 h after surgery,compared with those in open surgery group(P<0.05).The TNF-αand HMGB1 increased in both groups 24 h after surgery(P<0.05);but TNF-αand HMGB1 levels in minimally invasive group were lower than those in open surgery group 24 h after surgery(P<0.05).The complication rate of minimally invasive group(5.00%,2/40)was lower than that of ope

关 键 词：肠套叠 腹腔镜复位手术 传统开腹手术 复位成功率 并发症 

分 类 号：R726.5[医药卫生—儿科]