腹腔镜手术下不同固定方法治疗小儿回结型肠套叠的临床效果比较  

Comparison of clinical effects of different fixation methods under laparoscopic surgery in the treatment of children with gyrocollum intussusception

作　　者：周应成 刘文英[3] 周涛 王磊 ZHOU Ying-cheng;LIU Wen-ying;ZHOU Tao;WANG Lei(Medical College,University of Electronic Science and Technology of China,Chengdu 610054,China;Department of Pediatric Surgery,Dazhou Central Hospital,Dazhou 635000,China;Department of Pediatric Surgery,Sichuan Academy of Medical Sciences&Sichuan Provincial People′s Hospital,Chengdu 610072,China)

机构地区：[1]电子科技大学医学院,四川成都610054 [2]四川省达州市中心医院小儿外科,四川达州635000 [3]四川省医学科学院·四川省人民医院小儿外科,四川成都610072

出　　处：《实用医院临床杂志》2023年第6期170-173,共4页Practical Journal of Clinical Medicine

基　　金：四川省医学科研课题计划(编号:S21048)。

摘　　要：目的分析腹腔镜下回盲部-侧腹膜固定术与腹腔镜回肠-升结肠固定术治疗小儿回结型肠套叠的临床效果。方法收集2015年5月至2023年2月达州市中心医院收治的小儿回结型肠套叠117例,根据术中不同的固定方式分为回盲部-侧腹膜固定组(A组)62例及回肠-升结肠固定组(B组)55例,对比分析两组患儿的围术期指标、手术前后血清C反应蛋白水平、术后并发症发生率、随访效果、患儿家属满意度、住院费用及远期并发症。结果A组手术耗时、术后进食等待时间、住院天数、术后至肛门排气时间均短于B组,术后下床活动时间早于B组(P<0.05);两组治疗后血清CRP水平均升高,B组CRP水平高于A组(P<0.05);A组切口感染、切口疝及迟发性肠穿孔、坏死、粘连、复发等并发症发生率低于B组(P<0.05);两组患儿家属满意度及住院费用比较,差异无统计学意义(P>0.05)。结论腹腔镜回盲部-侧腹膜固定术与回肠-升结肠固定术治疗小儿回结型肠套叠均可能够获得良好效果,而回盲部-侧腹膜固定方法手术耗时、术后进食等待时间、平均住院天数、术后至肛门排气时间缩短,术后下床活动时间提前,术后并发症发生率更低。Objective To analyze the clinical effect of laparoscopic ileocecal lateral peritoneal fixation and laparoscopic ileal ascending colon fixation in the treatment of children with ileal intussusception.Methods One hundred and seventeen children with ileocecal intussusception admitted to Dazhou Central Hospital from May 2015 to February 2023 were collected.The sick children were divided into an ileocecal lateral peritoneal fixation group(group A,n=62)and an ileal ascending colon fixation group(group B,n=55).The perioperative indicators,serum C-reactive protein levels before and after surgery,postoperative complication rate,follow-up effect,family satisfaction,hospitalization costs and long-term complications of the two groups were compared and analyzed.Results The operative time,postoperative food waiting time,hospitalization days and time from postoperation to anal exhaust in the group A were shorter than those in the group B,and the postoperative time to get out of bed in the group A was earlier than that in the group B(P<0.05).After treatment,the serum CRP levels were increased in both groups,and the CRP levels in the group B were higher than those in the group A(P<0.05).The incidence of complications such as incision infection,incision hernia,delayed intestinal perforation,necrosis,adhesion and recurrence in the group A was lower than those in the group B(P<0.05).There was no statistically significant difference in satisfaction and hospitalization expenses between the two groups(P>0.05).Conclusions Both type of surgery can achieve good results in the treatment of children with ileocecal intussusception.However,the time of operation,postoperative fasting time,hospitalization and anal exhaust time of the ileocecal lateral peritoneum fixation method are shortened.The time to get out of bed after the operation by using the method is earlier.The incidence of postoperative complications of the method is lower.

关 键 词：腹腔镜下回盲部与侧腹膜固定 回肠与升结肠固定 小儿回结型肠套叠 围术期指标 预后 

分 类 号：R726.1[医药卫生—儿科]