摘要
目的:探讨腹腔镜手术治疗小儿胆总管囊肿的临床疗效。方法:选取2010年9月-2017年9月本院收治的先天性胆总管囊肿患儿32例为研究对象。按照随机数字表法将其分为研究组和对照组,各16例。对照组患儿行传统开腹手术,研究组患儿行腹腔镜手术。比较两组手术相关指标、手术前后的实验室指标水平、并发症及随访期间的疾病复发情况。结果:研究组平均手术时间、术中出血量、肛门排气时间、引流时间、住院时间均明显低于对照组,比较差异均有统计学意义(t=-9.802、-12.021、-4.422、-14.870、-6.531,P=0.000、0.000、0.000、0.000、0.000);术后,研究组丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、血清总胆红素(TBIL)均低于对照组,比较差异均有统计学意义(t=-2.140、-3.089、-2.373、-2.258,P=0.041、0.004、0.024、0.031);研究组术后无并发症发生,对照组术后切口感染4例(25.00%),比较差异有统计学意义(χ~2=4.571,P=0.033);随访期间研究组无复发,对照组复发2例(12.50%),比较差异无统计学意义(χ~2=2.133,P=0.484)。结论:相较于传统开腹手术,腹腔镜手术符合现代医学微创理念,治疗小儿先天性胆总管囊肿临床效果显著,可有效促进各项临床症状及体征的消退,降低术后并发症发生率与疾病复发率,改善实验室相关指标,提升手术疗效,具备临床实施意义与运用价值。
Objective：To investigate the clinical effect of laparoscopic surgery in treatment of choledochal cyst in children.Method：A total of 32 children with congenital choledochal cyst treated in our hospital from September 2010 to September 2017 were selected as the subjects.According to the random number table method,they were divided into study group and control group,16 cases in each group.The control group underwenttraditional laparotomy,and study group underwent laparoscopic surgery.The related indexes of operation,the levels of laboratory indexes before and after operation,the complications and the recurrence of the follow-up period between two groups were compared.Result：The average operative time,intraoperative blood loss,anal exhaust time,drainage time and hospitalization time in study group were significantly lower than those of control group,the differences were statistically significant（t=-9.802,-12.021,-4.422,-14.870,-6.531;P=0.000,0.000,0.000,0.000,0.000）.After operation,the alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,alkaline phosphatase（ ALP） and total bilirubin（TBIL） in study group were all lower than those of control group,the differences were statistically significant（t=-2.140,-3.089,-2.373,-2.258;P=0.041,0.004,0.024,0.031）.There were no complications after operation in study group,and 4 cases（25.00%） of postoperative incision infection in control group,the difference was statistically significant（χ~2=4.571,P=0.033）.During the follow-up period,there were no recurrence in study group and 2 cases（12.50%） in control group,the difference was not statistically significant（χ~2=2.133,P=0.484）.Conclusion：Compared with the traditional laparotomy,laparoscopic surgery accords with the modern medical minimally invasive concept.The clinical effect of laparoscopic surgery on congenital choledochal cyst in children is remarkable,can effectively promote the regression of the clinical symptoms and signs,reduce the rate of disease recurrence rate and p
作者
李伟坚
陈江谊
陈锐源
李志雄
冯燕琼
LI Weijian;CHENJiangyi;CHEN Ruiyuan(Jiangmen Central Hospital,Jiangmen 529000,Chin)
出处
《中国医学创新》
CAS
2018年第10期5-8,共4页
Medical Innovation of China
基金
江门市科技计划项目(江科[2016]98号-074)
关键词
腹腔镜手术
治疗
小儿胆总管囊肿
疗效
Laparoscopic surgery
Treatment
Choledochal cyst in children
Clinical effect
