引用本文:万成亮,海 波,白 强,张传勃,方 辉,黄纯锋,董克刚.经脐单孔腹腔镜手术治疗小儿复杂性阑尾炎的效果分析[J].中国临床新医学,2020,13(9):886-889.
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经脐单孔腹腔镜手术治疗小儿复杂性阑尾炎的效果分析
万成亮,海 波,白 强,张传勃,方 辉,黄纯锋,董克刚
650018 云南,昆明市儿童医院,昆明医科大学附属儿童医院普通外科
摘要:
[摘要] 目的 分析经脐单孔腹腔镜手术治疗小儿复杂性阑尾炎的效果。方法 选择2017-07~2019-10该院收治的复杂性阑尾炎患儿86例,采用随机数字表法将其分为开腹手术组和经脐单孔腹腔镜组,每组43例。开腹手术组行传统开腹手术治疗,经脐单孔腹腔镜组行经脐单孔腹腔镜手术治疗,对比两组患儿的治疗效果。结果 经脐单孔腹腔镜组手术时间、手术切口长度、术后肛门排气时间、首次下床活动时间、引流时间和住院时间均明显短于开腹手术组(P<0.05),术中出血量明显少于开腹手术组(P<0.05)。经脐单孔腹腔镜组术后视觉模拟量表(VAS)疼痛评分、止痛药使用率、并发症发生率均显著低于开腹手术组(P<0.05)。两组患儿术后第3天的白细胞(WBC)、C-反应蛋白(CRP)水平均较术前显著降低(P<0.05);但两组术前、术后第3天比较差异无统计学意义(P>0.05)。结论 经脐单孔腹腔镜手术治疗小儿复杂性阑尾炎具有较好的临床效果,可准确定位坏死阑尾,有效减轻术后疼痛,术后并发症较少,术后恢复快。
关键词:  经脐单孔腹腔镜  小儿  复杂性阑尾炎
DOI:10.3969/j.issn.1674-3806.2020.09.09
分类号:R 726.1
基金项目:云南省卫生科技计划项目(编号:2017NS110);昆明市卫生科技人才培养项目[编号:2020-SW(后备)-120]
Analysis of the effect of transumbilical single-port laparoscopic surgery on children with complicated appendicitis
WAN Cheng-liang, HAI Bo, BAI Qiang, et al.
Department of General Surgery, Kunming Children′s Hospital, Children′s Hospital Affiliated to Kunming Medical University, Yunnan 650018, China
Abstract:
[Abstract] Objective To analyze the effect of transumbilical single-port laparoscopic surgery on children with complicated appendicitis. Methods Eighty-six children with complicated appendicitis admitted to our hospital from July 2017 to October 2019 were selected and divided into laparotomy group and transumbilical single-port laparoscopic group by random number table method, with 43 cases in each group. The laparotomy group was treated with conventional laparotomy, and the transumbilical single-port laparoscopic group received transumbilical single-port laparoscopic surgery. The treatment effect was compared between the children in the two groups. Results The operation time, surgical incision length, postoperative anal exhaust time, time for first ambulation, drainage time, and hospitalization time in the transumbilical single-port laparoscopic group were significantly shorter than those in the laparotomy group(P<0.05), and the intraoperative blood loss in the transumbilical single-port laparoscopic group was significantly less than that in the laparotomy group(P<0.05). The postoperative Visual Analogue Scale(VAS) pain scores, utilization rate of analgesics, and the incidence of complications in the transumbilical single-port laparoscopic group were significantly lower than those in the laparotomy group(P<0.05). Compared with those before surgery, the levels of white blood cells(WBC) and C-reactive protein(CRP) in the two groups were significantly decreased three days after surgery(P<0.05). However, there were no significant differences between the two groups in the levels of WBC and CRP before surgery and three days after surgery(P>0.05). Conclusion Transumbilical single-port laparoscopic surgery has a good clinical effect on treatment of complicated appendicitis in children. It can accurately locate the necrotic appendixes, effectively reduce the postoperative pain, and makes the patients has less postoperative complications and rapid postoperative recovery.
Key words:  Transumbilical single-port laparoscopy  Children  Complicated appendicitis