小儿肾盂输尿管连接部梗阻应用腹腔镜下离断式肾盂成形术治疗的临床价值  

Clinical value of laparoscopic dismembered pyeloplasty in the treatment of ureteropyeloureteric junction obstruction in children

作　　者：陆巍[1] 刘丙辰 陶欣 欧文 王世鹏 LU Wei;LIU Bing-chen;TAO Xin(Department of Urology,Jilin Provincial People's Hospital,Changchun 130021,China)

机构地区：[1]吉林省人民医院泌尿外科,130021

出　　处：《中国实用医药》2023年第8期36-38,共3页China Practical Medicine

摘　　要：目的探讨小儿肾盂输尿管连接部梗阻(UPJO)应用腹腔镜下离断式肾盂成形术治疗的效果。方法30例UPJO患儿,根据治疗方法不同分为开放式手术组(14例)与腹腔镜手术组(16例)。开放式手术组采用开放式手术治疗,腹腔镜手术组采用腹腔镜下离断式肾盂成形术治疗。对比两组围手术期指标,术后并发症发生情况。结果腹腔镜手术组手术时间(115.76±29.19)min长于开放式手术组的(79.23±17.03)min,术中出血量(20.66±3.72)ml、术后镇痛剂用量(15.87±5.99)mg均少于开放式手术组的(40.87±4.17)ml、(35.82±4.59)mg,拔除引流管时间(5.22±0.99)d早于开放式手术组的(6.45±0.72)d,住院时间(7.18±1.17)d短于开放式手术组的(10.43±1.37)d,差异具有统计学意义(P<0.05)。腹腔镜手术组患儿的术后并发症发生率为6.25%,显著低于开放式手术组的35.71%,差异具有统计学意义(P<0.05)。结论腹腔镜离断式肾盂成形术对小儿UPJO治疗效果较佳,可缩短住院以及引流管拔除时间,降低患儿术后疼痛感,是一种并发症较少、临床价值较高的治疗方法。Objective To discuss the effect of laparoscopic dismembered pyeloplasty in the treatment of ureteropyeloureteric junction obstruction(UPJO)in children.Methods A total of 30 children with UPJO were divided into open surgery group(14 cases)and laparoscopic surgery group(16 cases)according to different treatment methods.The open surgery group was treated with open surgery,and the laparoscopic surgery group was treated with laparoscopic dismembered pyeloplasty.The perioperative indexes and occurrence of postoperative complications were compared between the two groups.Results The operative time of(115.76±29.19)min in laparoscopic surgery group was longer than that of(79.23±17.03)min in open surgery group;the intraoperative blood loss of(20.66±3.72)ml and postoperative analgesic dosage of(15.87±5.99)mg in laparoscopic surgery group were lower than those of(40.87±4.17)ml and(35.82±4.59)mg in open surgery group;the time of drainage tube removal of(5.22±0.99)d in laparoscopic surgery group was earlier than that of(6.45±0.72)d in open surgery group;the length of hospital stay of(7.18±1.17)d in laparoscopic surgery group was shorter than that of(10.43±1.37)d in open surgery group;the differences were statistically significant(P<0.05).The incidence of postoperative complications in laparoscopic surgery group was 6.25%,which was significantly lower than that of 35.71%in open surgery group,and the difference was statistically significant(P<0.05).Conclusion Laparoscopic dismembered pyeloplasty has a better effect on children with UPJO,which can shorten the length of hospital stay and time of drainage tube removal,and reduce postoperative pain in children.It is a treatment method with fewer complications and high clinical value.

关 键 词：肾盂输尿管连接部梗阻 腹腔镜下离断式肾盂成形术 双J管 

分 类 号：R726.9[医药卫生—儿科]