摘要
目的分析经脐单孔腹腔镜(NOTUS)应用于肾输尿管畸形患儿临床手术治疗中的效果及对患儿家属满意度的影响。方法以2013年1月至2014年12月中国医科大学附属盛京医院收治的采取NOTUS半肾切除术治疗的28例重复肾输尿管畸形患儿作为NOTUS组,以采取传统后腹腔镜半肾切除术治疗的23例重复肾输尿管畸形患儿作为对照组,对比两组患儿的术中情况包括手术时间、术中出血量、中转开腹率;术后情况包括术后住院时间、首次进食时间、术后并发症发生率及术后镇痛时间,于出院前调查两组患儿家属的满意度并进行统计对比;随访12个月,以手术瘢痕评估表评估两组患儿术后瘢痕情况,同时调查对比患儿家属对手术瘢痕的满意度。结果NOTUS组手术切口总长度、术中失血量、手术时间均显著低于对照组[(2.09±0.20)cm比(4.04±0.19)cm、(10.4±1.2)m L比(13.8±1.3)m L、(87±6)min比(94±7)min,P<0.01],NOTUS组术后镇痛时间、首次进食时间及术后住院时间均显著短于对照组[(2.3±1.1)d比(3.8±1.1)d、(8.9±2.5)h比(12.3±3.0)h、(6.1±1.1)d比(7.6±1.3)d,P<0.01];NOTUS组与对照组术后并发症发生率比较差异无统计学意义(P>0.05);NOTUS组患儿家属满意度显著优于对照组(P<0.01),总满意率显著高于对照组[96.43%(26/27)比69.57%(16/23)](P<0.05);术后随访12个月,NOTUS组瘢痕满意度显著高于对照组[78.57%(22/28)比39.13%(9/23),P<0.01];NOTUS组患儿家属满意率显著高于对照组[96.43%(27/28)比47.83%(11/23),P<0.01]。结论 NOTUS的应用优势明显,疗效确切,且术后瘢痕极小,患儿家属对术后瘢痕满意度高,可在肾输尿管畸形患儿的手术治疗中推广应用。
Objective To analyze the effect of natural orifice transumbilical surgery （NOTUS） on the clinical treatment of children with renal ureter malformation and its influence on the satisfaction degree of their family members. Methods The NOTUS group included 28 children with duplication of kidney and ureter malformation, who received NOTUS hemine- phrectomy in Shengjing Hospital Affiliated to China Medical University between Jan. 2013 and Dec. 2014. The control group included 23 children with duplication of kidney and ureter malformation, who received the traditional laparoseopic nephrectomy. A comparison between their intraoperative situation, including the operative time, intraoperative blood loss, the rate of transferring laparotomy surgery and their postoperative condition including postoperative hospital stay, initial feed- ing time, postoperative complications, and postoperative analgesia was done. Meanwhile, a statistical comparison between the satisfaction degrees of their family members was made as well. After 12 months of follow-up,two groups of ehildren were evaluated by surgical scar assessment, and their family members＇ satisfaction of the operation sear were also investigated and compared, llesltlts The total length of incision, blood loss and operation time in the NOTUS group were significantly lower than those in the control group[ （2.09 ±0.20） cm vs （4.04 ±0. 19） cm, （10.4 ± 1.2） mL vs （13.8 ± 1.3） mL, （ 87 ± 6 ） rain vs （94 ± 7 ） min,P 〈 0. 01 ]. The postoperative analgesia time, the first feeding time and postoperative hospi-tal stay of the NOTUS group were significantly less than those of the control group [ （2. 3 ± 1.1 ） d vs （3.8 ± 1.1 ） d, （ 8.9 ± 2. 5 ） h vs （ 12. 3 ± 3 ） h, （6. 1 ± 1.1 ） d vs （7. 6 ± 1.3） d, P 〈 0. 01 ]. There was no significant difference between the two groups in the incidence of postoperative complications （P 〉 0. 05 ）. The family satisfaction degree of the NOTUS group was significantly better than
出处
《医学综述》
2017年第7期1433-1436,1440,共5页
Medical Recapitulate
关键词
肾输尿管畸形
腹腔镜
经脐单孔
半肾切除术
术后瘢痕
Kidney and ureter malformation
Laparoscopy
Natural orifice transumbilical
Heminephrectomy
Postop-erative scar
